BRAD GOLDWORM (NPI# 1295889087) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295889087 |
| Entity Type | Individual |
| Full Name | BRAD GOLDWORM |
| Credential | P.A. |
| Practice Address |
2950 Limited Ln Nw Olympia WA 98502-4577 |
| Mailing Address |
Po Box 34584 Seattle WA 98124-1584 |
| Practice Telephone | 3602529777 |
| Mailing Telephone | 5092417349 |
| Mailing Fax Number | 5092417628 |
| Enumeration Date | 2007-01-22 |
| Last Update Date | 2016-03-18 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | PA10004755 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
PA10004755 | WA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | 8446841 | 05 |
| Street Address |
2950 LIMITED LN NW |
| City | OLYMPIA |
| State | WA |
| Zip Code | 98502-4577 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1558892828 | Pain Care Physicians Pllc | Pain Medicine | 2950 Limited Ln Nw, Olympia, WA 98502-4577 | 2017-03-27 |
| 1740627652 | Seattle Pain Center Medical Corporation | Pain Medicine | 2950 Limited Ln Nw, Olympia, WA 98502-4577 | 2013-05-31 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801409172 | Fanny Cordero | Interpreter | 1415 4th Ave W, Olympia, WA 98502 | 2020-08-26 |
| 1235762832 | Accessible Living Physical Therapy | Clinic/Center | 3524 7th Ave Se, Olympia, WA 98502 | 2020-02-21 |
| 1548807738 | Kaiser Foundation Health Plan of Washington | Pharmacy | 1200 Cooper Point Road Sw, Suite 100, Olympia, WA 98502 | 2019-12-06 |
| 1851946388 | Katherine Ann Vitela | Registered Nurse | 4909 Green Wood Dr Sw, Olympia, WA 98502 | 2019-08-01 |
| 1538632658 | Carmen Rae Breding | Massage Therapist | 2627 Capital Mall Dr Se, Olympia, WA 98502 | 2019-01-11 |
| 1285129155 | Fook Yee Cheung | Genetic Counselor, MS | 2010 Caton Way Sw Ste 102, Olympia, WA 98502 | 2018-06-24 |
| 1942724158 | William Coburn | Specialist/Technologist | 703 Lilly Road Ne, Suite 104, Olympia, WA 98502 | 2017-07-29 |
| 1225567415 | Thierry Buckner | Counselor | 2400 Bristol Court Sw, Olympia, WA 98502 | 2017-06-09 |
| 1619406048 | Trenton Reid | Massage Therapist | 2103 Harrison Ave Nw #2642, Olympia, WA 98502 | 2017-06-08 |
| 1962807305 | Richa Mehta | Dentist | 1530 Black Lake Boulevard, Suite A103, Olympia, WA 98502 | 2014-10-28 |
| Find all providers in zip 98502 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700345196 | Kara Lynn Kime | Physician Assistant | 1200 Cooper Point Rd Sw Ste 100, Olympia, WA 98502-1172 | 2019-03-15 |
| 1679056824 | Katharine Loco-marshall | Physician Assistant | 4816 She-nah-num Drive, Olympia, WA 98513 | 2018-09-13 |
| 1619285368 | Elizabeth R Mchugh | Physician Assistant | The Evergreen State College, Seminar 1 Rm 2110, Olympia, WA 98505-0001 | 2010-09-15 |
| 1023290962 | Cynthia Strohl Weissinger | Physician Assistant | 500 Lilly Rd Ne Ste 200, Olympia, WA 98506-5197 | 2007-12-03 |
| 1568659910 | Eric Lloyd Renk | Physician Assistant | 2401 Bristol Ct Sw, A104, Olympia, WA 98502-6003 | 2007-10-01 |
| 1629126842 | Susan Anne Kaisaki | Physician Assistant | 1212 Harrison Ave Nw, Olympia, WA 98502-5466 | 2007-01-05 |
| 1366523490 | Donna M Landry | Physician Assistant | 1603 Cooper Point Rd Nw, Olympia, WA 98502-8325 | 2006-10-17 |
| 1518931526 | Rickard D. Antles | Physician Assistant | 406 Yauger Way Sw Ste A, Olympia, WA 98502-8151 | 2006-02-15 |
| 1932104700 | Cynthia K Lobe | Physician Assistant | 3000 Limited Ln Nw, Olympia, WA 98502-2704 | 2005-06-16 |
| 1508189887 | Michelle D Smith | Physician Assistant | 615 Lilly Rd Ne, Olympia, WA 98506-5117 | 2010-03-01 |
| Find all providers in OLYMPIA | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.