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General NPI Number Information
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NPI Number | 1538278379
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Entity Type | Individual
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Provider Name | WILLIAM STUART GOULD MD
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Gender | Male
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Dates
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Enumeration Date | 08/29/2006
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 13118 121ST WAY NE SUITE 100
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City | KIRKLAND
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State | WA
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Zip | 98034-3004
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Country | US
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Telephone | 360-793-9776
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Fax | 360-793-7697
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Provider Business Mailing Address
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Address Line | PO BOX 1165
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City | GOLD BAR
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State | WA
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Zip | 98251-1165
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Country | US
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Telephone | 360-793-9776
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Fax | 360-793-7697
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QS0010X
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Taxonomy Name | Sports Medicine (Family Medicine) Physician
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License Number | 0019957
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License Number State | WA
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