Individual
PETER MYLES MCGOUGH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
13231 SE 36TH ST STE 110, BELLEVUE, WA 98006-7321
(425) 957-9000
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00018447
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0160766
L&I
WA
05
—
1013092824
—
WA
01
—
69480
INTERNAL ID-MOTOR VEHICLE ID
—
Enumeration date
10/27/2006
Last updated
08/21/2012
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