Provider Demographics
NPI:1912280462
Name:GOULDING, JOSHUA THOMAS (OD)
Entity Type:Individual
Prefix:DR
First Name:JOSHUA
Middle Name:THOMAS
Last Name:GOULDING
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2238 13TH AVE W LOWR UNIT
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98119-2437
Mailing Address - Country:US
Mailing Address - Phone:616-217-7604
Mailing Address - Fax:
Practice Address - Street 1:13550 AURORA AVE N
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98133-7512
Practice Address - Country:US
Practice Address - Phone:206-417-6920
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-09-21
Last Update Date:2011-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60239577152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist