MEDICARE: JAMES ROBERT GOOD M.A.

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
1	101Y00000X	Counselor
2	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1548460595
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES ROBERT GOOD M.A.

Provider Business Mailing Address
First Line	:	97 OSWEGO SMT
Second Line	:
City	:	LAKE OSWEGO
State	:	OR
Zip	:	97035-1078
Country	:	US
Telephone Number	:	503-819-9839
Fax Number	:

Provider Business Practice Location Address
First Line	:	1060 WEBBER ST
Second Line	:
City	:	THE DALLES
State	:	OR
Zip	:	97058-3749
Country	:	US
Telephone Number	:	541-296-5452
Fax Number	:	541-296-5263

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2007
Last Update Date	:	01/30/2025

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