Individual
SUSAN GODDARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CHW
Contact information
Practice address
PO BOX 546, GRESHAM, OR 97030-0132
(971) 373-4165
(971) 373-4165
Mailing address
PO BOX 546, GRESHAM, OR 97030-0132
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
THW000110230
OR
Other
Enumeration date
01/04/2024
Last updated
03/19/2025
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