Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207P00000X | Emergency Physician | MD60131057 | WA |
NPI | 1003891888 |
---|---|
Provider Name | Dr. Penelope Anne Goode |
First Address | Olympia, WA 98502-1575 |
Second Address | Olympia, WA 98506-5133 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/12/2005 |
Last Update Date | 01/03/2021 |