Active NPI
Gene Michael Gomez, MD
- Psychiatry Physician
- Auburn, WA
National Provider Identifier
1720033376
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychiatry Physician
- License
- MD60480708
- Practice address
- 4238 Auburn Way N
Auburn, WA 98002-1311 - Phone
- (253) 876-7600
- Fax
- (253) 876-7610
- NPI assigned
- May 23, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatry Physician | 2084P0800X | 8526911-1205 | UT | |
| Psychiatry Physician | 2084P0800X | MD60480708 | WA | Primary |
Addresses
Primary practice location
4238 Auburn Way N
Auburn, WA 98002-1311
Mailing address
325 E Pioneer
Puyallup, WA 98372-3265
Phone (253) 697-8400
Other practice location 1
325 E Pioneer
Puyallup, WA 98372-3265
Phone (253) 697-8400
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720033376 | Medicaid | UT |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1521244800000",
"number": "1720033376",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "325 E PIONEER",
"city": "PUYALLUP",
"state": "WA",
"postal_code": "983723265",
"telephone_number": "253-697-8400"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4238 AUBURN WAY N",
"city": "AUBURN",
"state": "WA",
"postal_code": "980021311",
"telephone_number": "253-876-7600",
"fax_number": "253-876-7610"
}
],
"practiceLocations": [
{
"address_1": "325 E Pioneer",
"address_purpose": "LOCATION",
"city": "Puyallup",
"state": "WA",
"postal_code": "983723265",
"country_code": "US",
"telephone_number": "253-697-8400",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOMEZ",
"first_name": "GENE",
"middle_name": "MICHAEL",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-23",
"last_updated": "2018-03-17",
"status": "A"
},
"taxonomies": [
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "UT",
"license": "8526911-1205",
"primary": false
},
{
"code": "2084P0800X",
"taxonomy_group": "",
"desc": "Psychiatry & Neurology, Psychiatry",
"state": "WA",
"license": "MD60480708",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1720033376",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Auburn, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.