Provider Demographics
NPI:1083768899
Name:GOODMAN, FRANCIS J (MD)
Entity Type:Individual
Prefix:
First Name:FRANCIS
Middle Name:J
Last Name:GOODMAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 34584
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1584
Mailing Address - Country:US
Mailing Address - Phone:509-241-7349
Mailing Address - Fax:509-241-7628
Practice Address - Street 1:6002 N LIDGERWOOD ST
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99208-1124
Practice Address - Country:US
Practice Address - Phone:509-482-4402
Practice Address - Fax:509-482-5068
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00019910207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8338006Medicaid
WA080189546Medicare PIN
WAP00135652Medicare PIN
WAG8872342Medicare PIN
WAGAB33009Medicare PIN
WAA07764Medicare UPIN
WAP00125198Medicare PIN