| Doctor Name: | DR. ANDREW MICHAEL GOODEILL |
| NPI Number: | 1013261684 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | DPM |
| License Number: | EL-1858 |
| Business Practice Address: | 1610 Bishop Rd Sw Ste 101 Tumwater, WA - 985127303 |
| Business Phone Number: | 3607543338 |
| Business Fax Number: | 3607534861 |
| Mailing Address: | 624 F St, CENTRALIA |
| State: | WA |
| Postal Code: | 985314620 |
| Phone Number: | 3603881897 |
| Fax Number: | |
| NPI Enumeration Date: | 11/05/2012 |
| NPI Last Update Date: | 01/17/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 390200000X |
| License Number: | EL-1858 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | CA |
| Taxonomy Type: | Student, Health Care |
| Taxonomy Classification: | Student in an Organized Health Care Education/Training Program |
| Taxonomy Specialization: | |
| Taxonomy Definition: | An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care. |