Individual
ETHAN ROY GOLD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
HS
Contact information
Practice address
1901 S UNION AVE STE 6007, TACOMA, WA 98405-1702
(818) 241-6780
(818) 241-6853
Mailing address
1901 S UNION AVE STE 6007, TACOMA, WA 98405-1702
(818) 241-6780
(818) 241-6853
Taxonomy
Speciality
Code
Description
License number
State
106S00000X
Behavior Technician
Primary
—
WA
Other
Enumeration date
08/16/2021
Last updated
08/16/2021
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