Individual
MARLENE JOYCE GOODMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
15935 NE 8TH ST STE A101, BELLEVUE, WA 98008-3918
(425) 644-5556
Mailing address
15935 NE 8TH ST STE A101, BELLEVUE, WA 98008-3918
(425) 644-5556
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00012550
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA00012550
STATE LICENSE
WA
Enumeration date
03/06/2007
Last updated
07/08/2007
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