Individual
KELLY GOODNIGHT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
SUDP
Contact information
Practice address
3629 S D ST, TACOMA, WA 98418-6813
(253) 798-6576
Mailing address
3629 S D ST, TACOMA, WA 98418-6813
(253) 649-1406
(253) 649-1381
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
CP 60050042
WA
Other
Enumeration date
02/13/2014
Last updated
08/14/2024
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