Provider Demographics
NPI:1013261684
Name:GOODEILL, ANDREW (DPM)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:
Last Name:GOODEILL
Suffix:
Gender:
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1610 BISHOP RD SW BLDG 7
Mailing Address - Street 2:
Mailing Address - City:TUMWATER
Mailing Address - State:WA
Mailing Address - Zip Code:98512-7303
Mailing Address - Country:US
Mailing Address - Phone:360-754-3338
Mailing Address - Fax:360-753-4861
Practice Address - Street 1:1610 BISHOP RD SW BLDG 7
Practice Address - Street 2:
Practice Address - City:TUMWATER
Practice Address - State:WA
Practice Address - Zip Code:98512-7303
Practice Address - Country:US
Practice Address - Phone:360-754-3338
Practice Address - Fax:360-753-4861
Is Sole Proprietor?:No
Enumeration Date:2012-11-05
Last Update Date:2025-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPO60317586213E00000X, 213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist