Individual
DR. MICHAEL MOSHE GOODBLATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
413 LILLY RD NE, OLYMPIA, WA 98506-5133
(360) 486-6402
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
MD60969403
WA
207QH0002X
Hospice and Palliative Medicine (Family Medicine) Physician
Primary
MD60969403
WA
Other
Enumeration date
07/14/2010
Last updated
08/23/2019
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