Individual
CLARA MICHELLE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
3530 S VAL VISTA DR STE C101, GILBERT, AZ 85297-7318
(602) 491-0703
(833) 661-1781
Mailing address
840 E MCKELLIPS RD STE 105, MESA, AZ 85203-9654
(602) 491-0703
(480) 631-0581
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
8716
AZ
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125904
—
AZ
Enumeration date
07/31/2021
Last updated
08/01/2023
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