Provider Demographics
NPI:1952444093
Name:GOODWIN, SANDRA K (MSW)
Entity Type:Individual
Prefix:MS
First Name:SANDRA
Middle Name:K
Last Name:GOODWIN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:829 PIONEER RD
Mailing Address - Street 2:
Mailing Address - City:BROOKINGS
Mailing Address - State:OR
Mailing Address - Zip Code:97415-9216
Mailing Address - Country:US
Mailing Address - Phone:509-995-5878
Mailing Address - Fax:
Practice Address - Street 1:1355 OAK ST
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-3566
Practice Address - Country:US
Practice Address - Phone:541-556-6355
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-15
Last Update Date:2022-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health