Individual
MICHELLE DAWN GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
420 NE MASON ST, PORTLAND, OR 97211-3479
(503) 546-9402
(503) 546-9415
Mailing address
4531 SE BELMONT ST STE 100, PORTLAND, OR 97215-1675
(503) 546-9402
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201801078LPN
OR
Other
Enumeration date
08/09/2018
Last updated
08/09/2018
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