Penny Goudelock is a Medical in Everett, Washington. Penny Goudelock practices all healthcare services and medical treatments related to Medical. The NPI Number for Penny Goudelock is 1043433352. The last update date is 2020-04-14.
Penny Goudelock's current location address is 1100 Pacific Ave, Everett, Washington. You can contact this provider via phone number 4253884075. The mailing address for Penny Goudelock is 1100 Pacific Ave, Everett, Washington. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Penny Goudelock |
|---|---|
| Address | 1100 Pacific Ave, Everett, Washington |
| Phone Number | 4253884075 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | PA |
NPI Number Detail
| NPI Number | 1043433352 |
|---|---|
| Provider Enumeration Date | 2007-04-11 |
| Last Updated Date | 2020-04-14 |
Provider Mailing Address Detail
| Address | 1100 Pacific Ave |
|---|---|
| City | Everett |
| State | Washington (WA) |
| Post Code | 982014261 |
| Phone Number | 4253884075 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Medical |
|---|---|
| Taxonomy | 363Am0700X |
| Licence No | PA10005160 |
|
Definition: A licensed healthcare professional who practices medicine under physician supervision focusing on medical diagnoses and treatment. |
|
Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8485898 | WA | -- |
Post Comment/ Review Below
What is the Penny Goudelock's 1043433352?
The Penny Goudelock's NPI (National Provider Identifier) Number is 1043433352. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Penny Goudelock is geographically located?
The Penny Goudelock is physically situated at the following location: 1100 Pacific Ave, Everett, WA, 982014261.
What is Penny Goudelock's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Penny Goudelock's specialized field of practice is Medical, and the corresponding taxonomy code that categorizes this area of specialization is 363Am0700X.
On what date was the 1043433352 assigned to Penny Goudelock?
The Penny Goudelock was issued its 1043433352 on 2007-04-11, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
As of what date was the information pertaining to Penny Goudelock, such as address, specialty, and other details, last reviewed and confirmed to be accurate?
The information related to Penny Goudelock, including its address, specialty, and other relevant details, was last reviewed and confirmed to be accurate on 2020-04-14.