Healthcare Provider Details

I. General information

NPI: 1922918309
Provider Name (Legal Business Name): ASHLYN GOODIN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 F ST STE 224
EUREKA CA
95501-1041
US

IV. Provider business mailing address

PO BOX 1799
MENDOCINO CA
95460-1799
US

V. Phone/Fax

Practice location:
  • Phone: 707-832-2929
  • Fax: 707-968-4779
Mailing address:
  • Phone: 707-684-9875
  • Fax: 707-968-4779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License Number
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: