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NPI Code Detail

MEDICARE: DR. PENELOPE ANNE GOODE M.D.

MEDICARE: DR. PENELOPE ANNE GOODE M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207P00000XEmergency Medicine PhysicianMD60131057WA

General Provider Information

NPI Number : 1003891888
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. PENELOPE ANNE GOODE M.D.
Provider Business Mailing Address
First Line : 413 LILLY RD
Second Line : MS:DDH09
City : OLYMPIA
State : WA
Zip : 98502-1575
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 413 LILLY RD NE
Second Line : OLYMPIA EMERGENCY SERVICES
City : OLYMPIA
State : WA
Zip : 98506-5133
Country : US
Telephone Number : 360-493-4554
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/14/2005
Last Update Date : 03/01/2021

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