Provider Demographics
NPI:1184222317
Name:GOTO, ALAN (PARAMEDIC)
Entity type:Individual
Prefix:
First Name:ALAN
Middle Name:
Last Name:GOTO
Suffix:
Gender:M
Credentials:PARAMEDIC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8245 15TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-4339
Mailing Address - Country:US
Mailing Address - Phone:206-226-6483
Mailing Address - Fax:
Practice Address - Street 1:401 2ND AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98104-3858
Practice Address - Country:US
Practice Address - Phone:206-386-1483
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-09
Last Update Date:2020-10-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAES60296288341600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes341600000XTransportation ServicesAmbulance