Organization
WINLOCK PEDIATRICS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. VIOLETA M GOMEZ MD (OWNER)
(470) 733-0321
Entity
Organization
Contact information
Practice address
19540 FRONT ST NE, POULSBO, WA 98370-7316
(564) 218-6135
Mailing address
2341 NE WINLOCK WAY, POULSBO, WA 98370-9258
(470) 733-0321
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
—
—
261QM0855X
Adolescent and Children Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60912725
STATE LICENSE
WA
Enumeration date
09/07/2022
Last updated
07/02/2024
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