Doctor Name: | MISS HEATHER BRONWYN GOOD |
NPI Number: | 1225308026 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA |
License Number: | PA60261659 |
Business Practice Address: | 77 N Main St Coupeville, WA - 982399556 |
Business Phone Number: | 3606784440 |
Business Fax Number: | 3606789244 |
Mailing Address: | Po Box 746, COUPEVILLE |
State: | WA |
Postal Code: | 982390746 |
Phone Number: | 3606784440 |
Fax Number: | 3606789244 |
NPI Enumeration Date: | 01/10/2012 |
NPI Last Update Date: | 01/10/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | PA60261659 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |