Basic Information
| Provider Information | |||||||||
| NPI: | 1598864068 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GOBER | ||||||||
| FirstName: | LORNA | ||||||||
| MiddleName: | ANN | ||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 709 W ORCHARD DR | ||||||||
| Address2: | SUITE #4 | ||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982251766 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3603188800 | ||||||||
| FaxNumber: | 3603181085 | ||||||||
| Practice Location | |||||||||
| Address1: | 3130 SQUALICUM PKWY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | BELLINGHAM | ||||||||
| State: | WA | ||||||||
| PostalCode: | 982251940 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 3607560382 | ||||||||
| FaxNumber: | 3607565184 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/21/2006 | ||||||||
| LastUpdateDate: | 07/24/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | MD00039064 | WA | Y | Allopathic & Osteopathic Physicians | Family Medicine |
ID Information
| ID | Type | State | Issuer | Description | 1007GO | 01 | WA | REGENCE | OTHER | G8883758 | 01 | WA | MEDICARE PTAN | OTHER | 8547275 | 05 | WA | MEDICAID | 0251096 | 01 | WA | DEPT. OF LABOR AND INDUSTRIES | OTHER | 9765341 | 01 | WA | AETNA | OTHER |