Goucher, George T

Goucher, George T is an individual health care provider with primary practice located at 1718 E Kessler Blvd , Longview WA 98632-1842. He recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant, which is considered as his primary health care specialty. Goucher, George T can be contacted via phone (360) 747-5800.

Contact Information

Primary practice address
1718 E Kessler Blvd Longview WA 98632-1842
Phone: (360) 747-5800
Fax: (360) 575-3846
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X PA10002266 Washington

Profile Details

NPI number 1548267560
LBN Legal business name Goucher, George T
Credentials Physician Assistant (PA)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2005
Last updated Jul 30th, 2012 - about 14 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548267560 NPPES
Washington Other 8924393 CRIME VICTIMS
Washington Other 134674 CRIME VICTIMS
Washington MEDICAID 8330862 CRIME VICTIMS
Washington Other 970017023 CRIME VICTIMS

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