Individual
KATHLEEN GOODWIN GOFORTH
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
L.AC.
Contact information
Practice address
727 W BURNSIDE, PORTLAND, OR 97209
(503) 228-4533
Mailing address
6401 NE 33RD, PORTLAND, OR 97211
(503) 228-4533
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC00602
OR
Other
Enumeration date
05/09/2006
Last updated
07/08/2007
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