Individual
JACKIE GOODEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
215 W LOCUST ST, STANFIELD, OR 97875-9704
(541) 969-2264
Mailing address
890 W ORCHARD AVE, HERMISTON, OR 97838-1569
(541) 969-2264
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
201330204LPN
OR
Other
Enumeration date
01/29/2026
Last updated
01/29/2026
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