Individual
KEVIN GOODNOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
847 NE 19TH AVE, PORTLAND, OR 97232-2684
(503) 552-6203
(503) 552-6208
Mailing address
847 NE 19TH AVE, PORTLAND, OR 97232-2684
(503) 552-6203
(503) 552-6208
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
09/09/2008
Last updated
09/09/2008
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