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General NPI Number Information
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NPI Number | 1336724376
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Entity Type | Individual
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Provider Name | NELLIE GOODIN APRN
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Gender | Female
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Dates
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Enumeration Date | 03/11/2021
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Last Update Date | 10/07/2025
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Provider Practice Location Address
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Address Line | 1802 YAKIMA AVE STE 307
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City | TACOMA
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State | WA
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Zip | 98405-5305
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Country | US
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Telephone | 253-627-1244
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Fax | 253-627-6576
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Provider Business Mailing Address
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Address Line | 1802 YAKIMA AVE STE 307
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City | TACOMA
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State | WA
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Zip | 98405-5305
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Country | US
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Telephone | 253-627-1244
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Fax | 253-627-6576
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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 | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | AP70000763
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 363LA2100X
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Taxonomy Name | Acute Care Nurse Practitioner
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License Number | 3015919
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License Number State | KY
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