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NPI Code Detail

MEDICARE: KLAUS T GOTTLIEB MD, PLLC

MEDICARE: KLAUS T GOTTLIEB MD, PLLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207RG0100XGastroenterology PhysicianMD00036894WA

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1146938OTHERWAWA LABOR & INDUSTRIES
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1053386391
Entity Type Code : Organization
Provider Name (Legal Business Name) : KLAUS T GOTTLIEB MD, PLLC
Provider Business Mailing Address
First Line : 122 N RAYMOND RD
Second Line : STE 20
City : SPOKANE VALLEY
State : WA
Zip : 99206-6832
Country : US
Telephone Number : 509-926-1770
Fax Number : 509-228-9542
Provider Business Practice Location Address
First Line : 12128 N DIVISION ST
Second Line : STE 164
City : SPOKANE
State : WA
Zip : 99218-1905
Country : US
Telephone Number : 509-455-3453
Fax Number :
Authorized Official
Title or Position : DOCTOR
Name : DR. KLAUS GOTTLIEB
Credential : MD, PLLC
Telephone Number : 509-455-3453
Provider Enumeration Date : 02/21/2006
Last Update Date : 08/22/2020

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