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NPI Code Detail

MEDICARE: ELIZABETH K GOODWIN LICSW

MEDICARE: ELIZABETH K GOODWIN LICSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerLW 60237256WA

General Provider Information

NPI Number : 1164782181
Entity Type Code : Individual
Provider Name (Legal Business Name) : ELIZABETH K GOODWIN LICSW
Provider Business Mailing Address
First Line : 511 28TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-4161
Country : US
Telephone Number : 206-290-3221
Fax Number :
Provider Business Practice Location Address
First Line : 511 28TH AVE E
Second Line :
City : SEATTLE
State : WA
Zip : 98112-4161
Country : US
Telephone Number : 206-290-3221
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2012
Last Update Date : 05/23/2012

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Directions to “ ELIZABETH K GOODWIN LICSW” Practice Location

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