Individual
ELICIA GRACE GOODWIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
16528 E DESMET CT STE 3100, SPOKANE VALLEY, WA 99216-3522
(509) 944-9440
Mailing address
PO BOX 421, LIBERTY LAKE, WA 99019-0421
(866) 747-2455
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA61518385
WA
Other
Enumeration date
11/08/2023
Last updated
02/19/2024
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