Provider Demographics
NPI:1467698431
Name:GOODWIN, BETH ANN (HOMEOPATH)
Entity Type:Individual
Prefix:
First Name:BETH
Middle Name:ANN
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:HOMEOPATH
Other - Prefix:
Other - First Name:BETH
Other - Middle Name:ANN
Other - Last Name:ZUMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 11315
Mailing Address - Street 2:
Mailing Address - City:BAINBRIDGE ISLAND
Mailing Address - State:WA
Mailing Address - Zip Code:98110-5315
Mailing Address - Country:US
Mailing Address - Phone:206-622-7913
Mailing Address - Fax:
Practice Address - Street 1:533 MADISON AVE N STE F
Practice Address - Street 2:
Practice Address - City:BAINBRIDGE ISLAND
Practice Address - State:WA
Practice Address - Zip Code:98110-1749
Practice Address - Country:US
Practice Address - Phone:206-842-2702
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-12-23
Last Update Date:2023-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00020096225700000X
175L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175L00000XOther Service ProvidersHomeopath
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0146763OtherDEPARTMENT OF LABOR AND INDUSTRIES