Provider Demographics
NPI:1285655969
Name:GOODMAN, KAREN M (ARNP)
Entity Type:Individual
Prefix:
First Name:KAREN
Middle Name:M
Last Name:GOODMAN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:709 W ORCHARD DR
Mailing Address - Street 2:SUIRE 4
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-1766
Mailing Address - Country:US
Mailing Address - Phone:360-318-8800
Mailing Address - Fax:360-318-1085
Practice Address - Street 1:1610 GROVER ST
Practice Address - Street 2:SUITE D1
Practice Address - City:LYNDEN
Practice Address - State:WA
Practice Address - Zip Code:98264-1539
Practice Address - Country:US
Practice Address - Phone:360-354-1333
Practice Address - Fax:360-354-5399
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2015-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP30004920363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA423898057OtherGROUP HEALTH COOPERATIVE
WA0500009160OtherRAILROAD MEDICARE
WA42079OtherREGENCE BLUESHIELD
WA8924736OtherL & I (CRIME VICTIM)
WA0128913OtherL & I (REGULAR)
WA9625161Medicaid
WA8924736OtherL & I (CRIME VICTIM)
WAGAB11154Medicare PIN