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General NPI Number Information
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NPI Number | 1740289883
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Entity Type | Individual
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Provider Name | DEBRA A GOULD M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/20/2005
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Last Update Date | 02/20/2024
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Provider Practice Location Address
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Address Line | 504 N 40TH AVE
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City | YAKIMA
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State | WA
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Zip | 98908-4311
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Country | US
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Telephone | 509-966-9480
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Fax | 509-225-2702
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Provider Business Mailing Address
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Address Line | 3800 SUMMITVIEW AVE
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City | YAKIMA
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State | WA
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Zip | 98902-2715
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Country | US
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Telephone | 509-248-7849
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Fax | 509-248-8291
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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 | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | MD00027853
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License Number State | WA
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