# GEORGE T GOUCHER

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1548267560
- **Gender:** Man
- **Credential:** PA

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | PA10002266 | WA | Yes |

## Other

- **Enumeration date:** 07/05/2005
- **Last updated:** 07/30/2012

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 134674 | LABOR & IND. | WA |
| 05 | — | 8330862 | — | WA |
| 01 | — | 8924393 | CRIME VICTIMS | WA |
| 01 | — | 970017023 | RR MEDICARE | — |