MEDICARE: ITALIA ANNETTE GODINEZ

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	101YA0400X	Addiction (Substance Use Disorder) Counselor	CDPT.CO.70091215	WA

General Provider Information

NPI Number	:	1780518852
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ITALIA ANNETTE GODINEZ

Provider Business Mailing Address
First Line	:	1005 W MAXWELL AVE APT 2
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-2639
Country	:	US
Telephone Number	:	208-997-0465
Fax Number	:

Provider Business Practice Location Address
First Line	:	910 W BOONE AVE
Second Line	:
City	:	SPOKANE
State	:	WA
Zip	:	99201-5029
Country	:	US
Telephone Number	:	509-325-7232
Fax Number	:

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

Provider Enumeration Date	:	06/11/2026
Last Update Date	:	06/11/2026

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Directions to “ ITALIA ANNETTE GODINEZ ” Practice Location

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