Individual
MR. SCOTT FRANKLIN GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
1100 9TH AVE, MS:X6-ORT, SEATTLE, WA 98101-2756
(206) 223-7530
(206) 341-0195
Mailing address
1100 9TH AVE, MS:M4-PFS, SEATTLE, WA 98101-2756
(206) 515-5811
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
PA17801
CA
363AS0400X
Surgical Physician Assistant
Primary
PA60801172
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
FT721A
SA MEDICAL PHYSICIANS OF CA PTAN
CA
01
—
MEDICAL LICENSE
PA 17801
CA
Enumeration date
12/06/2006
Last updated
10/08/2018
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