Provider Demographics
NPI:1285604892
Name:GOLDMAN, JUNE S (MD)
Entity type:Individual
Prefix:DR
First Name:JUNE
Middle Name:S
Last Name:GOLDMAN
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5952 BLACKSTONE WAY
Mailing Address - Street 2:LAKE SPOKANE COMMUNITY HEALTH CENTER
Mailing Address - City:NINE MILE FALLS
Mailing Address - State:WA
Mailing Address - Zip Code:99026-4900
Mailing Address - Country:US
Mailing Address - Phone:509-464-3627
Mailing Address - Fax:509-466-9517
Practice Address - Street 1:5952 BLACKSTONE WAY
Practice Address - Street 2:LAKE SPOKANE COMMUNITY HEALTH CENTER
Practice Address - City:NINE MILE FALLS
Practice Address - State:WA
Practice Address - Zip Code:99026-4900
Practice Address - Country:US
Practice Address - Phone:509-464-3627
Practice Address - Fax:509-466-9517
Is Sole Proprietor?:No
Enumeration Date:2006-01-25
Last Update Date:2009-03-31
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00020871207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA080010938OtherRR MEDICARE
WA23020OtherL&I
WA1034735Medicaid
WA080010938OtherRR MEDICARE
WA1034735Medicaid