Provider Demographics
NPI:1275611733
Name:GOODNESS, ADRIA YVONNE (CNM, PMHNP)
Entity Type:Individual
Prefix:
First Name:ADRIA
Middle Name:YVONNE
Last Name:GOODNESS
Suffix:
Gender:F
Credentials:CNM, PMHNP
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Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 820211
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97282-1211
Mailing Address - Country:US
Mailing Address - Phone:971-220-8338
Mailing Address - Fax:503-894-9515
Practice Address - Street 1:106 SW WOODS ST
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97201-4739
Practice Address - Country:US
Practice Address - Phone:971-220-8338
Practice Address - Fax:503-894-9515
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2023-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
OR200350075NP363LX0001X, 2084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0001XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerObstetrics & Gynecology
No2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry