Provider Demographics
NPI:1225519093
Name:GOODNIGHT, DIANE L (MSW)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:L
Last Name:GOODNIGHT
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:DIANE
Other - Middle Name:L
Other - Last Name:SMITH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3950 KEENE RD
Mailing Address - Street 2:
Mailing Address - City:WEST RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99353-4901
Mailing Address - Country:US
Mailing Address - Phone:509-942-3130
Mailing Address - Fax:
Practice Address - Street 1:3950 KEENE RD
Practice Address - Street 2:
Practice Address - City:WEST RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99353-4901
Practice Address - Country:US
Practice Address - Phone:509-942-3130
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-28
Last Update Date:2018-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW60692163104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker