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Contact Information

JOHN B GOSSOM, MD
689 AIRPORT CENTER DR
STE B
FRIDAY HARBOR, WA98250
 Phone: 360-378-1338
 Fax: 360-378-1830
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Geriatric Medicine

207QG0300X 08 Physician/Family Practice
Indicates primary specialty

NPI Profile & details for JOHN B GOSSOM · (Male)

NPI Number 1245221886
Status Active
Credentials MD
Entity Individual
Enumeration date 11/02/2005
Last updated 03/04/2011 - About 15 years ago
Sole proprietor 1 Yes
Identifiers
  • WA License # MD00018422
  • Other 5403470 CCN
  • Other 912109329 CIGNA BEECH ST
  • Other 912109329 COMMUNITY HEALTHPLAN OF W
  • Other 8937843 CRIME VICTIMS
  • Other 8101404 DSHS
  • Other 912109329 FIRST CHOICE
  • Other 532300001 GROUP HEALTH
  • Other 0152514 LABOR AND INDUSTRIES
  • Other MD00018422 LICENSE NUMBER
  • Other 912109329 PREMERA BLUE CROSS
  • Other 5877GO REGENCE BLUE SHIELD
  • Other 912109329 TAX ID
  • Other 912109329 TRIWEST
  • Other 98250A003 TRIWEST
  • Other 361929500 US DEPT OF LABOR
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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