Individual
MR. LYNN E GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
OD
Contact information
Practice address
425 N MAIN, MYRTLE CREEK, OR 97457
(541) 863-5258
(541) 863-6000
Mailing address
PO BOX 6006, MYRTLE CREEK, OR 97457
(541) 863-5258
(541) 863-6000
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
1481ATI
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
226175
—
OR
Enumeration date
08/31/2006
Last updated
03/28/2024
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