Individual
DOROTHY G GONZAGA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
2202 S CEDAR ST STE 330, TACOMA, WA 98405-2318
(253) 272-5127
(253) 272-0811
Mailing address
2202 S CEDAR ST STE 330, TACOMA, WA 98405-2318
(253) 272-5127
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP30007463
WA
363LF0000X
Family Nurse Practitioner
Primary
AP30007463
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9651001
—
WA
01
—
AP30007463
WA LICENSE
WA
Enumeration date
10/18/2006
Last updated
06/21/2019
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