Provider Demographics
NPI:1700996436
Name:GULDEN, KIRK D (MD)
Entity Type:Individual
Prefix:
First Name:KIRK
Middle Name:D
Last Name:GULDEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:709 W ORCHARD DR STE 4
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1766
Mailing Address - Country:US
Mailing Address - Phone:360-318-8800
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:2075 BARKLEY BLVD STE 105
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98226-6614
Practice Address - Country:US
Practice Address - Phone:360-617-3345
Practice Address - Fax:360-671-1354
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2009-02-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NC24251207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8937872Medicaid
WA8949517OtherL&I CRIME VICTIMS
WA6436GUOtherREGENCE
WA8527533Medicaid
9553OtherPARTNERS
WA0242968OtherL&I
37872OtherBCBS
WA8949517OtherL&I CRIME VICTIMS
NC8937872Medicaid
WAG8878358Medicare PIN