Individual
VANESSA GOODLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
15675 AMBAUM BLVD SW, BURIEN, WA 98166-2523
(206) 631-3011
Mailing address
15675 AMBAUM BLVD SW, BURIEN, WA 98166-2523
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP60932009
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LP60932009
NURSING LICENSE
WA
Enumeration date
04/19/2019
Last updated
04/19/2019
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