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General NPI Number Information
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NPI Number | 1598887861
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Entity Type | Individual
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Provider Name | TIMOTHY W GOODRICH D.O.
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Gender | Male
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Dates
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Enumeration Date | 04/06/2007
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Last Update Date | 06/08/2021
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Provider Practice Location Address
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Address Line | 825 SE BISHOP BLVD STE 601
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City | PULLMAN
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State | WA
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Zip | 99163-5512
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Country | US
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Telephone | 509-334-5876
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Fax | 509-332-8793
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Provider Business Mailing Address
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Address Line | 825 SE BISHOP BLVD SUITE 601
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City | PULLMAN
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State | WA
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Zip | 99163-5517
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Country | US
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Telephone | 509-334-5876
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Fax | 509-332-8793
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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 | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 0530995
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 774
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 005600
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License Number State | AZ
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Taxonomy #4
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | 63863
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License Number State | GA
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Taxonomy #5
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Taxonomy Code | 207Y00000X
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Taxonomy Name | Otolaryngology Physician
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License Number | OP60500221
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License Number State | WA
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