Individual
SUZANNE GOODNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
400 NE MOTHER JOSEPH PL, VANCOUVER, WA 98664-3200
(360) 514-2142
(360) 514-6820
Mailing address
PO BOX 60000, FILE 74839, SAN FRANCISCO, CA 94160-1600
(360) 514-2142
(360) 514-6820
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA100004753
WA
363A00000X
Physician Assistant
PA10004753
WA
363AM0700X
Medical Physician Assistant
PA155112
OR
Other
Enumeration date
05/24/2006
Last updated
10/31/2011
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