| Doctor Name: | JAMES WILLIAM GOODRICK |
| NPI Number: | 1023203353 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | |
| Business Practice Address: | 14195 Sw Millikan Way Beaverton Beaverton, OR - 970052307 |
| Business Phone Number: | 5032380769 |
| Business Fax Number: | |
| Mailing Address: | 11559 Sw Davies Rd, Beaverton BEAVERTON |
| State: | OR |
| Postal Code: | 970078324 |
| Phone Number: | 5033072148 |
| Fax Number: | |
| NPI Enumeration Date: | 09/10/2007 |
| NPI Last Update Date: | 01/15/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YA0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Addiction (Substance Use Disorder) |
| Taxonomy Definition: | |