DR. MARVIN J GOTTSCHALL (NPI# 1982662169) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1982662169 |
| Entity Type | Individual |
| Full Name | DR. MARVIN J GOTTSCHALL |
| Credential | MD |
| Practice Address |
701 Hospital Loop 92 Mdg Ste 132 Fairchild Afb WA 99011 |
| Mailing Address |
5505 S Custer Rd Spokane WA 99223-1628 |
| Practice Telephone | 5092472617 |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171000000X | Military Health Care Provider | MD00004559 | WA | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871636555 | Marvin J Gottschall Jr. | Dentist | 1821 N Leclerc Rd. #1, Cusick, WA 99119-5015 | 2007-02-14 |
| Street Address |
701 HOSPITAL LOOP 92 MDG STE 132 |
| City | FAIRCHILD AFB |
| State | WA |
| Zip Code | 99011 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669939732 | Ruth Ann Sunde | Social Worker | 92d Medical Group/sgow, 701 Hospital Loop, Suite 259, Fairchild Afb, WA 99011 | 2019-02-26 |
| 1164992491 | Michael Thomas Stevens | Military Health Care Provider | 100 Hospital Loop, Fairchild Afb, WA 99011 | 2018-11-29 |
| 1174032569 | Elizabeth Andrews | Registered Nurse | 400 W Fairchild Highway, Fairchild Afb, WA 99011 | 2017-09-28 |
| 1770031171 | Mariah Combs | Behavioral Analyst | 5298 B Sycamore Street, Fairchild Afb, WA 99011 | 2016-09-14 |
| 1770960957 | Usv Optical Inc. | Eyewear Supplier (Equipment, not the service) | 101 W. Spaatz Rd., Bldg 2465, Fairchild Afb, WA 99011 | 2015-04-27 |
| 1306191689 | Patricia Kaye Catrow | Family Medicine | 701 Hospital Loop Bldg 9000, Fairchild Afb, WA 99011 | 2012-07-23 |
| 1205102761 | 92nd Medical Group | Military/U.S. Coast Guard Pharmacy | 103 Saatz Rd, Fairchild Afb, WA 99011 | 2012-03-29 |
| 1992078554 | Alyssa Marie Degeyter | Community Health Worker | 7272 A Nebraska Ave, Fairchild Air Force Base, WA 99011 | 2012-02-13 |
| 1730317728 | Nicholas James Graham | Military Health Care Provider | 2504 S.chicago St, Fairchild Afb, WA 99011 | 2009-06-29 |
| 1922232099 | Pocco S Bussey | Military Health Care Provider | 92 Medical Group, Flight Medicine Clinic, Fairchild, WA 99011 | 2009-05-05 |
| Find all providers in zip 99011 | ||||
| Taxonomy Code | 171000000X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Active duty military health care providers not otherwise classified who need to be separately identified for operational, clinical, or administrative processes. |
| Notes: [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760996235 | Brian Scott Loomis | Military Health Care Provider | 701 Hospital Loop Ste 42, Fairchild Afb, WA 99011-8702 | 2017-11-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699324962 | Elizabeth Thi Nguyen | Military Health Care Provider | 27831 37th Ave S, Auburn, WA 98001-1065 | 2019-09-09 |
| 1144549379 | Samantha Colleen Myers | Military Health Care Provider | 2000 W Marine View Dr # 2134, Everett, WA 98207-2900 | 2010-05-27 |
| 1306020359 | Felipson Zabala Ramos Jr. | Military Health Care Provider | 2001 Sixth Ave, Suite 2705, Us Air Force, Seattle, WA 98312-2547 | 2007-12-27 |
| 1437367257 | Pin Y Yau | Military Health Care Provider | 4735 E Marginal Way S, Seattle, WA 98134-2388 | 2007-05-18 |
| 1700940434 | Charles Edwin Olson | Military Health Care Provider | One Boone Rd, Bremerton, WA 98312 | 2006-12-20 |
| 1013013309 | Michael Matthew Dickman | Military Health Care Provider | 9040 Jackson Avenue Family Medicine Department, Tacoma, WA 98431 | 2006-09-15 |
| 1003920380 | Norman Albert Gosch | Military Health Care Provider | 17th and C St., Bldg. 11582, Fort Lewis, WA 98433 | 2006-08-17 |
| 1518935931 | Eric A. Lange | Military Health Care Provider | 312 Fitzsimmons Ave, Tacoma, WA 98341 | 2006-03-10 |
| 1770555393 | Paul Mccafferty Ryan | Military Health Care Provider | Attn: Mchj-sop, Madigan Army Medical Center, Tacoma, WA 98431-0001 | 2006-02-07 |
| 1033196845 | Arturo Herida Castro | Military Health Care Provider | 1519 Alaskan Way S, Seattle, WA 98134-1102 | 2005-12-22 |
| Find all providers with the same taxonomy | ||||
| City | FAIRCHILD AFB |
| Zip Code | 99011 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.