Provider Demographics
NPI:1164481099
Name:GOINEY, ROBERT C (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:C
Last Name:GOINEY
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 24147
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-0147
Mailing Address - Country:US
Mailing Address - Phone:206-292-6233
Mailing Address - Fax:206-292-7764
Practice Address - Street 1:1229 MADISON ST
Practice Address - Street 2:SUITE 900
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3586
Practice Address - Country:US
Practice Address - Phone:206-292-6233
Practice Address - Fax:206-292-7764
Is Sole Proprietor?:No
Enumeration Date:2006-03-20
Last Update Date:2014-11-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000184812085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA7822109Medicaid
WA55900OtherL & I
G08172OtherREGENCE
WA300042763OtherRAILROAD
WA55674OtherL & I
WA8632309Medicaid
910849248OtherTAX ID
WE4663OtherREGENCE
WA000160300Medicare PIN
A06818Medicare UPIN
G08172OtherREGENCE