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NPI Code Detail

MEDICARE: BRIANNA JEAN GOODELL

MEDICARE: BRIANNA JEAN GOODELL
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
1104100000XSocial Worker

General Provider Information

NPI Number : 1427904754
Entity Type Code : Individual
Provider Name (Legal Business Name) : BRIANNA JEAN GOODELL
Provider Business Mailing Address
First Line : 6605 SE LAKE RD
Second Line :
City : PORTLAND
State : OR
Zip : 97222-2161
Country : US
Telephone Number : 503-655-8471
Fax Number :
Provider Business Practice Location Address
First Line : 6605 SE LAKE RD
Second Line :
City : MILWAUKIE
State : OR
Zip : 97222-2161
Country : US
Telephone Number : 503-655-8471
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/09/2026
Last Update Date : 03/09/2026

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Directions to “ BRIANNA JEAN GOODELL ” Practice Location

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