Individual
MRS. JILL RITA GOODRICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MBA OTR/L
Contact information
Practice address
8011 112TH STREET CT E, PUYALLUP, WA 98373-7814
(253) 848-0662
(253) 848-8567
Mailing address
9315 GRAVELLY LAKE DR SW, SUITE 306, LAKEWOOD, WA 98499-1574
(253) 581-5200
(253) 581-5203
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
0720000317
VT
225X00000X
Occupational Therapist
Primary
OT60233608
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0282598
L&I PROVIDER NUMBER
WA
Enumeration date
08/22/2006
Last updated
04/14/2014
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