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General NPI Number Information
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NPI Number | 1376323964
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Entity Type | Individual
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Provider Name | MS. KIMBERLY GOODMAN
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Gender | Female
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Dates
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Enumeration Date | 10/02/2023
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Last Update Date | 10/02/2023
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Provider Practice Location Address
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Address Line | 4415 S 150TH ST
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City | TUKWILA
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State | WA
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Zip | 98188-2305
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Country | US
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Telephone | 206-901-7615
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Fax | 206-901-7607
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Provider Business Mailing Address
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Address Line | 4415 S 150TH ST
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City | TUKWILA
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State | WA
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Zip | 98188-2305
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Country | US
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Telephone |
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Fax |
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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 | 1041S0200X
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Taxonomy Name | School Social Worker
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License Number |
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License Number State |
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