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NPI Code Detail

MEDICARE: SOFIA M GOFF SUDPT

MEDICARE: SOFIA M GOFF SUDPT
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
1101YA0400XAddiction (Substance Use Disorder) CounselorCO61274085WA

General Provider Information

NPI Number : 1326774688
Entity Type Code : Individual
Provider Name (Legal Business Name) : SOFIA M GOFF SUDPT
Provider Business Mailing Address
First Line : 11900 BEACON AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98178-2811
Country : US
Telephone Number : 206-772-6900
Fax Number : 206-772-6566
Provider Business Practice Location Address
First Line : 11900 BEACON AVE S
Second Line :
City : SEATTLE
State : WA
Zip : 98178-2811
Country : US
Telephone Number : 206-772-6900
Fax Number : 206-772-6566
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/28/2022
Last Update Date : 07/28/2022

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Directions to “ SOFIA M GOFF SUDPT” Practice Location

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