Individual
MS. MARY GOODMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
1600 E JEFFERSON ST, SUITE A5, SEATTLE, WA 98122-5698
(206) 320-2404
(206) 320-4747
Mailing address
3210 S CHARLES ST, SEATTLE, WA 98144-3215
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT00005072
WA
Other
Enumeration date
06/25/2007
Last updated
07/08/2007
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