Individual
FATIME O GODA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
400 S 43RD ST, SOUTHLAKE CLINIC INC PS, RENTON, WA 98055-5714
(425) 228-3440
Mailing address
PO BOX 34876, SEATTLE, WA 98124-1876
(425) 656-5412
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD00040727
WA
208M00000X
Hospitalist Physician
Primary
MD00040727
WA
Other
Enumeration date
11/21/2006
Last updated
02/24/2017
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