Individual
DR. KENNETH THOMAS GOODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
KEN GOODELL
Contact information
Practice address
1515 VILLAGE DR, EMERGENCY DEPARTMENT, COTTAGE GROVE, OR 97424-9700
(541) 942-0511
Mailing address
PO BOX 1193, CORVALLIS, OR 97339-1193
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
DO150423
OR
Other
Enumeration date
02/25/2007
Last updated
11/10/2020
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