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Individual

MR. GLENN THOMAS GOLEEKE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LMP

Contact information

Practice address
3161 ELLIOTT AVE STE 102, SEATTLE, WA 98121-1016
(206) 282-6700
Mailing address
3161 ELLIOTT AVE STE 102, SEATTLE, WA 98121-1016
(206) 282-6700

Taxonomy

Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
MA00011325
WA

Other

Enumeration date
11/03/2008
Last updated
11/03/2008
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