Individual
JACK GOLDMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 2ND ST NE, AUBURN, WA 98002-4902
(253) 833-3650
Mailing address
33634 7TH PL SW, FEDERAL WAY, WA 98023-5004
(253) 833-3650
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD00017877
WA
207R00000X
Internal Medicine Physician
Primary
MD00017877
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1730100
—
WA
Enumeration date
05/28/2006
Last updated
01/05/2026
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