Provider Demographics
NPI:1336157056
Name:GOFFE, BERNARD SAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:BERNARD
Middle Name:SAUL
Last Name:GOFFE
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Gender:M
Credentials:MD
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Mailing Address - Street 1:1730 MINOR AVENUE
Mailing Address - Street 2:STE 1000 DERMATOLOGY ASSOCIATES PLLC
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98101-1498
Mailing Address - Country:US
Mailing Address - Phone:206-267-2100
Mailing Address - Fax:206-267-2101
Practice Address - Street 1:1730 MINOR AVENUE
Practice Address - Street 2:STE 1000 DERMATOLOGY ASSOCIATES PLLC
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-1498
Practice Address - Country:US
Practice Address - Phone:206-267-2100
Practice Address - Fax:206-267-2101
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2008-03-14
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Provider Licenses
StateLicense IDTaxonomies
WAMD00008765207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1311406Medicaid
A04559Medicare UPIN
WA1311406Medicaid