MEDICARE: MARGARET GODDARD MSN CNP

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	363LA2200X	Adult Health Nurse Practitioner	210391040NP-PP	OR

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1902863517
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARGARET GODDARD MSN CNP

Provider Business Mailing Address
First Line	:	1312 SW WASHINGTON ST
Second Line	:
City	:	PORTLAND
State	:	OR
Zip	:	97205-2327
Country	:	US
Telephone Number	:	503-535-1150
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 VINE ST
Second Line	:
City	:	CINCINNATI
State	:	OH
Zip	:	45220-2213
Country	:	US
Telephone Number	:	513-861-3100
Fax Number	:

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

Provider Enumeration Date	:	04/27/2006
Last Update Date	:	10/26/2016

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