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General NPI Number Information
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NPI Number | 1396013132
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Entity Type | Individual
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Provider Name | NANCY BETH GOLDOV PSYD, BC-DMT
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Gender | Female
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Dates
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Enumeration Date | 12/08/2011
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Last Update Date | 01/31/2017
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Provider Practice Location Address
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Address Line | 1314 NE 43RD ST STE 209
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City | SEATTLE
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State | WA
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Zip | 98105-5832
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Country | US
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Telephone | 206-979-9743
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Fax |
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Provider Business Mailing Address
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Address Line | 5802 17TH AVE NE
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City | SEATTLE
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State | WA
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Zip | 98105-2512
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Country | US
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Telephone | 206-979-9743
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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 | 103TC0700X
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Taxonomy Name | Clinical Psychologist
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License Number | PY-60246450
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License Number State | WA
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