Goldworm, Brad
Goldworm, Brad is an individual health care provider with primary practice located at 2950 Limited Ln Nw , Olympia WA 98502-4577. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Medical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Medical is his primary health care specialty. Goldworm, Brad can be contacted via phone (360) 252-9777.Contact Information
Primary practice address
2950 Limited Ln Nw
Olympia WA 98502-4577
Phone: (360) 252-9777
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Medical | 363AM0700X | PA10004755 | Washington |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | PA10004755 | Washington |
Profile Details
| NPI number | 1295889087 |
|---|---|
| LBN Legal business name | Goldworm, Brad |
| Credentials | Physician Assistant (PA) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 22nd, 2007 |
| Last updated | Jan 7th, 2021 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1295889087 | NPPES |
| Washington | MEDICAID | 8446841 |
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