Healthcare Provider Details

I. General information

NPI: 1730397332
Provider Name (Legal Business Name): CYNTHIA GOOD MS, LMHCA, IBCLC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/18/2007
Last Update Date: 06/11/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7981 168TH AVE NE STE 116
REDMOND WA
98052-0911
US

IV. Provider business mailing address

PO BOX 2402
LYNNWOOD WA
98036-2402
US

V. Phone/Fax

Practice location:
  • Phone: 425-399-5053
  • Fax:
Mailing address:
  • Phone: 425-399-5053
  • Fax: 425-332-7393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174N00000X
TaxonomyLactation Consultant (Non-RN)
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMC60407074
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: