Individual
MRS. MISTY MARIE CRICK-GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LE
Contact information
Practice address
20622 108TH STREET CT E, BONNEY LAKE, WA 98391-7969
(253) 332-3173
Mailing address
20622 108TH STREET CT E, BONNEY LAKE, WA 98391-7969
(253) 332-3173
Taxonomy
Speciality
Code
Description
License number
State
246Z00000X
Other Specialist/Technologist
Primary
9756
CA
Other
Enumeration date
11/15/2022
Last updated
11/15/2022
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