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General NPI Number Information
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NPI Number | 1437820164
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Entity Type | Individual
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Provider Name | AUDREY ANN GOETTL RN
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Gender | Female
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Dates
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Enumeration Date | 09/22/2021
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Last Update Date | 11/13/2025
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Provider Practice Location Address
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Address Line | 1920 100TH ST SE STE B
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City | EVERETT
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State | WA
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Zip | 98208-3832
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Country | US
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Telephone | 425-312-0202
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Fax | 425-312-0263
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Provider Business Mailing Address
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Address Line | 602 E NOB HILL BLVD
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City | YAKIMA
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State | WA
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Zip | 98901-3534
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Country | US
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Telephone | 509-248-3334
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP61512106
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 163WP2201X
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Taxonomy Name | Ambulatory Care Registered Nurse
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License Number | RN60970555
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License Number State | WA
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