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NPI Code Detail

MEDICARE: MICHELLE GOODMAN MSW

MEDICARE: MICHELLE GOODMAN MSW
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
1101YM0800XMental Health Counselor
2104100000XSocial WorkerSC61559332WA
3225400000XRehabilitation Practitioner

General Provider Information

NPI Number : 1750060539
Entity Type Code : Individual
Provider Name (Legal Business Name) : MICHELLE GOODMAN MSW
Provider Business Mailing Address
First Line : 7700 300TH ST NW
Second Line :
City : STANWOOD
State : WA
Zip : 98292-5841
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 7700 300TH ST NW
Second Line :
City : STANWOOD
State : WA
Zip : 98292-5841
Country : US
Telephone Number : 360-209-8430
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/18/2023
Last Update Date : 09/17/2025

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