Individual
DR. JOSE JAVIER GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PHD
Contact information
Practice address
1 COLVILLE ST, NESPELEM, WA 99155
(509) 634-2642
Mailing address
1 COLVILLE ST, NESPELEM, WA 99155
(509) 634-2642
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
00958
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1980812
—
WA
Enumeration date
08/02/2006
Last updated
07/08/2007
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