Provider Demographics
NPI:1831268093
Name:HALL, JUDITH GOSLIN
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:GOSLIN
Last Name:HALL
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:JUDITH
Other - Middle Name:GOSLIN
Other - Last Name:HALL
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:6358 HAWTHORN LANE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:BRITISH COLUMBIA
Mailing Address - Zip Code:V6T 2J6
Mailing Address - Country:CA
Mailing Address - Phone:604-228-1233
Mailing Address - Fax:
Practice Address - Street 1:4480 OAK STREET
Practice Address - Street 2:BCCH L408
Practice Address - City:VANCOUVER
Practice Address - State:BRITISH COLUMBIA
Practice Address - Zip Code:V6H 3V4
Practice Address - Country:CA
Practice Address - Phone:604-875-2850
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA0252-09-MD00012623207SG0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207SG0201XAllopathic & Osteopathic PhysiciansMedical GeneticsClinical Genetics (M.D.)