Individual
DR. RONALD S GOLDBERG
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
MD PHD
Contact information
Practice address
4525 3RD AVE SE, STE 200, LACEY, WA 98503-1010
(360) 412-8909
(360) 412-8954
Mailing address
4525 3RD AVE SE, STE 200, LACEY, WA 98503-1010
(360) 412-8909
(360) 412-8954
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD00017869
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1054675
—
WA
Enumeration date
07/01/2005
Last updated
07/08/2007
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