Individual
DR. BERNARDO HADDOCK LOBO GOULART
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, MS
Contact information
Practice address
825 EASTLAKE AVE E, SEATTLE, WA 98109-4405
(206) 667-2778
(206) 288-1435
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 667-2778
(206) 288-1435
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD 00048618
WA
207RX0202X
Medical Oncology Physician
Primary
MD 00048618
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0277110
L&I
WA
05
—
1184734501
—
WA
Enumeration date
08/30/2006
Last updated
09/13/2012
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