Bryan Kristoffer Gonzales Gomez

Individual provider Active NPI Registered Nurse · Steilacoom, WA

NPI 1609514397 · NPPES record last updated Oct 4, 2025

Key facts

NPI
1609514397
Entity type
Individual (NPI type 1)
Primary specialty
Registered Nurse 163W00000X
License
RN61075740 (WA)
Practice address
1610 Lafayette St
P.O Box 881009
Steilacoom, WA 98388-1307
Phone
(347) 909-8738
NPI assigned
May 24, 2022
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
RN61075740WAMDRegistered Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X RN61075740 WA Yes

Addresses

Primary practice location

1610 Lafayette St
P.O Box 881009
Steilacoom, WA 98388-1307

Mailing address

1610 Lafayette St
P.O Box 881009
Steilacoom, WA 98388-1307

Other providers in Steilacoom, WA

All providers in Steilacoom, WA · Registered Nurse in Washington

Sources for this page

Verify at the official NPI Registry.