Individual
DR. MIKEL RAY GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
405 BLACK HILLS LN SW STE F, OLYMPIA, WA 98502-8661
(360) 357-4778
(360) 357-4590
Mailing address
5438 140TH AVE SW, ROCHESTER, WA 98579-9712
(360) 754-8852
(360) 357-4590
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00014506
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1000348
—
WA
01
—
16802
L&I
WA
01
—
G05688
REGENCE
WA
Enumeration date
11/17/2006
Last updated
07/08/2007
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