Individual
MYRON LEE GOLDBERG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
UNIVERSITY OF WASHINGTON MEDICAL CTR, 1959 NE PACIFIC ST, SEATTLE, WA 98195-6157
(206) 598-4295
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
PY00001795
WA
103TR0400X
Rehabilitation Psychologist
Primary
PY00001795
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3516
INTERNAL ID-MOTOR VEHICLE ID
—
05
—
8352270
—
WA
01
—
P00088051
RAIL ROAD MEDICARE
WA
Enumeration date
10/27/2006
Last updated
10/10/2008
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