Provider Demographics
NPI:1952052623
Name:GODINHO, MADALYN RAYE (PHARMD)
Entity Type:Individual
Prefix:
First Name:MADALYN
Middle Name:RAYE
Last Name:GODINHO
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:MADALYN
Other - Middle Name:RAYE
Other - Last Name:SEIDL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:253 CHAPMAN RD
Mailing Address - Street 2:
Mailing Address - City:CASTLE ROCK
Mailing Address - State:WA
Mailing Address - Zip Code:98611-9658
Mailing Address - Country:US
Mailing Address - Phone:360-749-4826
Mailing Address - Fax:
Practice Address - Street 1:1615 DELAWARE ST
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-2367
Practice Address - Country:US
Practice Address - Phone:360-414-2000
Practice Address - Fax:360-442-6843
Is Sole Proprietor?:No
Enumeration Date:2022-01-14
Last Update Date:2022-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH61181753183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist