Provider Demographics
NPI:1831913946
Name:GODDARD, ERICA (PHD)
Entity type:Individual
Prefix:DR
First Name:ERICA
Middle Name:
Last Name:GODDARD
Suffix:
Gender:X
Credentials:PHD
Other - Prefix:DR
Other - First Name:EJAE
Other - Middle Name:
Other - Last Name:GODDARD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PHD
Mailing Address - Street 1:9638 56TH AVE S
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98118-5713
Mailing Address - Country:US
Mailing Address - Phone:785-393-7982
Mailing Address - Fax:
Practice Address - Street 1:9638 56TH AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98118-5713
Practice Address - Country:US
Practice Address - Phone:785-393-7982
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-11-14
Last Update Date:2024-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist