Individual
MR. KEVIN ADAM GOODELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
505 S 336TH ST STE 500, FEDERAL WAY, WA 98003-8300
(206) 962-3535
Mailing address
3420 ILLINOIS ST, GREAT LAKES, IL 60088-3120
(847) 688-2251
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
—
—
Other
Enumeration date
01/23/2008
Last updated
10/29/2019
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