Provider Demographics
NPI:1467196089
Name:GODDARD, APRIL M (CRM)
Entity Type:Individual
Prefix:
First Name:APRIL
Middle Name:M
Last Name:GODDARD
Suffix:
Gender:F
Credentials:CRM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:389 SW SCALEHOUSE CT STE 130
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-3241
Mailing Address - Country:US
Mailing Address - Phone:541-306-4446
Mailing Address - Fax:541-306-2011
Practice Address - Street 1:389 SW SCALEHOUSE CT STE 130
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97702-3241
Practice Address - Country:US
Practice Address - Phone:541-306-4446
Practice Address - Fax:541-306-2011
Is Sole Proprietor?:No
Enumeration Date:2022-04-21
Last Update Date:2022-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR22-CRM-902175T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist