Dirk a. Gouge, D.O.

Primary specialty

Orthopaedic Surgery PhysicianTaxonomy code 207X00000X

License

OP00001549 Issued in WA

Legal business name

DIRK A. GOUGE, D.O.

Practice address

1004 Caroline St
Port Angeles, WA 98362-3902

Phone

(360) 457-1500

Fax

(360) 457-1599

NPI assigned

Dec 14, 2007

Last updated

Dec 14, 2007By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Debra Kiesser

Title

Claims Biller

Phone

(360) 457-1500

Specialties & licenses 1

Addresses

Other identifiers 1

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1197590400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1197590400000",
    "number": "1023291812",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1004 CAROLINE ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623902",
            "telephone_number": "360-457-1500",
            "fax_number": "360-457-1599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1004 CAROLINE ST",
            "city": "PORT ANGELES",
            "state": "WA",
            "postal_code": "983623902",
            "telephone_number": "360-457-1500",
            "fax_number": "360-457-1599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DIRK A. GOUGE, D.O.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-12-14",
        "last_updated": "2007-12-14",
        "status": "A",
        "authorized_official_last_name": "KIESSER",
        "authorized_official_first_name": "DEBRA",
        "authorized_official_title_or_position": "CLAIMS BILLER",
        "authorized_official_telephone_number": "360-457-1500",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": "WA",
            "license": "OP00001549",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7116429",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Patrick Dewitt, COTA
• Darcy Deyling, LMHC-A
• Ellen Dezellem
• Jessica A Dibari, D.O.
• Amy Lee Dibello
• Ianir Divinsky, MD
• Miklo Jashua Dixon, BHT,CNA
• Dixons Recovery Ranch Outreach
• Jaymes Allison Doane, CDP
• Rebecca E Doherty, LDO

• Orthopaedic Surgery Physician in Port Angeles, WA
• Providers in Port Angeles, WA by specialty
• Orthopaedic Surgery Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 14, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.