Individual
GEORGE T GOUCHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1718 E KESSLER BLVD, LONGVIEW, WA 98632-1842
(360) 747-5800
(360) 575-3846
Mailing address
PO BOX 3002, LONGVIEW, WA 98632-0302
(360) 747-5800
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10002266
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
134674
LABOR & IND.
WA
05
—
8330862
—
WA
01
—
8924393
CRIME VICTIMS
WA
01
—
970017023
RR MEDICARE
—
Enumeration date
07/05/2005
Last updated
07/30/2012
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