Organization
DIRK A. GOUGE, D.O.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. DEBRA KIESSER (CLAIMS BILLER)
(360) 457-1500
Entity
Organization
Contact information
Practice address
1004 CAROLINE ST, PORT ANGELES, WA 98362-3902
(360) 457-1500
(360) 457-1599
Mailing address
1004 CAROLINE ST, PORT ANGELES, WA 98362-3902
(360) 457-1500
(360) 457-1599
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
OP00001549
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7116429
—
WA
Enumeration date
12/14/2007
Last updated
12/14/2007
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