Provider Demographics
NPI:1992928030
Name:GOLAN, RALPH T (MD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:T
Last Name:GOLAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7522 20TH AVE NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-4402
Mailing Address - Country:US
Mailing Address - Phone:206-524-8966
Mailing Address - Fax:206-524-8951
Practice Address - Street 1:7522 20TH AVE NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98115-4402
Practice Address - Country:US
Practice Address - Phone:206-524-8966
Practice Address - Fax:206-524-8951
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD000153462083P0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0500XAllopathic & Osteopathic PhysiciansPreventive MedicinePreventive Medicine/Occupational Environmental Medicine