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General NPI Number Information
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NPI Number | 1013261684
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Entity Type | Individual
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Provider Name | ANDREW GOODEILL DPM
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Gender | Male
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Dates
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Enumeration Date | 11/05/2012
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Last Update Date | 05/06/2025
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Provider Practice Location Address
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Address Line | 1610 BISHOP RD SW BLDG 7
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City | TUMWATER
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State | WA
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Zip | 98512-7303
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Country | US
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Telephone | 360-754-3338
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Fax | 360-753-4861
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Provider Business Mailing Address
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Address Line | 1610 BISHOP RD SW BLDG 7
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City | TUMWATER
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State | WA
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Zip | 98512-7303
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Country | US
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Telephone | 360-754-3338
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Fax | 360-753-4861
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 213E00000X
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Taxonomy Name | Podiatrist
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License Number | PO60317586
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License Number State | WA
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