Provider Demographics
NPI:1467856161
Name:GOLDING, DUSTIN WADE (PA-C)
Entity Type:Individual
Prefix:MR
First Name:DUSTIN
Middle Name:WADE
Last Name:GOLDING
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:2004 W 36TH PL
Mailing Address - Street 2:
Mailing Address - City:KENNEWICK
Mailing Address - State:WA
Mailing Address - Zip Code:99337-3803
Mailing Address - Country:US
Mailing Address - Phone:509-396-7487
Mailing Address - Fax:
Practice Address - Street 1:945 GOETHALS DR
Practice Address - Street 2:STE. 300
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-3552
Practice Address - Country:US
Practice Address - Phone:509-943-3196
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-10-09
Last Update Date:2014-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant