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General NPI Number Information
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NPI Number | 1962453860
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Entity Type | Organization
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Legal Business Name | EMERGENCY MEDICINE ASSOCIATES PC
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Dates
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Enumeration Date | 05/15/2006
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Last Update Date | 01/05/2022
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Provider Practice Location Address
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Address Line | 600 NE 92ND AVE
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City | VANCOUVER
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State | WA
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Zip | 98664-3225
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Country | US
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Telephone | 360-514-2000
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Fax | 360-514-6820
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Provider Business Mailing Address
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Address Line | PO BOX 742997
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City | LOS ANGELES
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State | CA
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Zip | 90074-2997
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Country | US
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Telephone | 781-280-1773
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Fax | 781-280-1814
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Authorized Official
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Title or Position | MD/AUTHORIZED OFFICIAL
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Name | DANIEL M GORECKI
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Credential | MD
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Telephone | 360-514-2142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QE0002X
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Taxonomy Name | Emergency Care Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 601287343
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License Number State | WA
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