Individual
JOY KATHERINE GOODWIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
427 12TH ST, PLUMMER, ID 83851-4000
(208) 686-1931
Mailing address
427 12TH ST, PLUMMER, ID 83851-4000
(208) 686-1931
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
59865
CA
363A00000X
Physician Assistant
PA61191213
WA
363AM0700X
Medical Physician Assistant
Primary
PA-2505
ID
Other
Enumeration date
08/13/2021
Last updated
08/07/2024
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