DR. GLENN T GOODWIN (NPI# 1346384013) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1346384013 |
| Entity Type | Individual |
| Full Name | DR. GLENN T GOODWIN |
| Credential | PHD |
| Practice Address |
555 Dayton St Suite E Edmonds WA 98020-3601 |
| Practice Telephone | 2066630816 |
| Practice Fax Number | 4256728655 |
| Mailing Telephone | 2066630816 |
| Mailing Fax Number | 4256728655 |
| Enumeration Date | 2007-02-16 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | PY00001999 | WA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | L&I PROVIDER NO. | 113963 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1275161036 | Glenn Goodwin | Student in an Organized Health Care Education/Training Program | 20900 Biscayne Blvd, Aventura, FL 33180-1407 | 2020-03-29 |
| Street Address |
555 DAYTON ST SUITE E |
| City | EDMONDS |
| State | WA |
| Zip Code | 98020-3601 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396725263 | Jacqueline A Mccoy | Registered Nurse | 555 Dayton St, Ste C, Edmonds, WA 98020 | 2006-01-18 |
| 1265820187 | Kristi L Dahlman, Ms, Lmhc, Inc | Counselor | 555 Dayton St, Suite A2, Edmonds, WA 98020-3601 | 2014-12-30 |
| 1972866820 | Emily Ruth Lovelett | Massage Therapist | 555 Dayton St, Suite G, Edmonds, WA 98020-3601 | 2012-06-15 |
| 1265673420 | Kendra Erin Higa | Marriage & Family Therapist | 555 Dayton St, Suite H, Edmonds, WA 98020-3601 | 2009-03-18 |
| 1962619866 | Matthew Daniel Flugstad | Dentist | 555 Dayton St, Suite B, Edmonds, WA 98020 | 2007-05-17 |
| 1841349446 | Virginia M. Buzzell | Psychologist | 555 Dayton St, Ste D, Edmonds, WA 98020-3476 | 2007-01-10 |
| 1134281462 | Claude Oliver Mccoy | Counselor | 555 Dayton St, Suite C, Edmonds, WA 98020-3601 | 2006-12-14 |
| 1306919733 | P Roger Hillerstrom | Counselor | 555 Dayton St, Suite C, Edmonds, WA 98020-3601 | 2006-11-15 |
| 1760552970 | Judy Ann Craft | Massage Therapist | 555 Dayton St, Suite G, Edmonds, WA 98020-3601 | 2006-11-08 |
| 1437236825 | Doni A. Kwak | Psychologist | 555 Dayton St, Suite J-1, Edmonds, WA 98020-3601 | 2006-11-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538688189 | Jennifer Ducharme | Massage Therapist | 51 W. Dayton St 304, Edmonds, WA 98020 | 2017-09-14 |
| 1164959987 | Emily Grooms | Counselor | 406 Main St Ste 115c, Edmonds, WA 98020 | 2017-05-11 |
| 1427449255 | Victoria Janssen | Registered Nurse | 2225 95th Pl W, Edmonds, WA 98020 | 2015-02-16 |
| 1922496553 | Paktia Pharmacy LLC | Pharmacy | 315 5th Ave S Unit #c, Edmonds, WA 98020 | 2015-01-06 |
| 1770928491 | Sarah Campbell | Counselor | 10016 Edmonds Way, Ste C #185, Edmonds, WA 98020 | 2013-05-08 |
| 1568765170 | Sondra Beres | Marriage & Family Therapist | 300 Admiral Way Ste 203, Edmonds, WA 98020 | 2010-12-21 |
| 1649586777 | Kelly Druin Sievertson | Social Worker | 144 Railroad Ave, Suite 212, Edmonds, WA 98020 | 2010-08-26 |
| 1588817233 | Everard Jimenez Espinosa | Anesthesiology | 911-12th Ave. North, Edmonds, WA 98020 | 2008-10-28 |
| 1811109705 | Dawud Raamah | Dentist | 7935 216th St Sw # D, # D, Edmonds, WA 98020 | 2007-05-04 |
| 1437225430 | Edmonds Vision Center Ps Inc | Optometrist | 201 5th Ave S Ste 102, Edmonds, WA 98020 | 2006-11-28 |
| Find all providers in zip 98020 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902901101 | Nora M Thompson | Clinical Neuropsychologist | 8318 196th St Sw, Edmonds, WA 98026-6434 | 2006-09-13 |
| 1700907342 | Roderick K Mahurin | Clinical Neuropsychologist | 8318 196th St Sw, 2nd Floor, Edmonds, WA 98026-6434 | 2007-04-02 |
| 1811021553 | Jennifer R. Blair | Clinical Neuropsychologist | 8318 196th St Sw, Edmonds, WA 98026-6434 | 2007-03-15 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841757010 | Corianne Raychael Lawrence | Clinical Neuropsychologist | 112 N 14th St, Selah, WA 98942-1713 | 2019-02-25 |
| 1588138333 | Mynd Group LLC | Clinical Neuropsychologist | 1066 View Ridge Dr, Oak Harbor, WA 98277-8265 | 2019-01-15 |
| 1588163208 | Johanah Y Kang | Clinical Neuropsychologist | 2013 South 19th Street, Tacoma, WA 98405 | 2018-02-08 |
| 1669850681 | Neuropsychological Services of The South Sound LLC | Clinical Neuropsychologist | 2620 R W Johnson Rd Sw Ste 204, Tumwater, WA 98512-6133 | 2015-05-11 |
| 1710372412 | Daniela Ferdico | Clinical Neuropsychologist | 2101 112th Ave Ne, Suite 100, Bellevue, WA 98004-2944 | 2015-03-31 |
| 1689069502 | Erica K Johnson | Clinical Neuropsychologist | 19000 33rd Ave W Ste 100, Lynnwood, WA 98036-4750 | 2015-03-30 |
| 1659776474 | Rodger Meinz | Clinical Neuropsychologist | 12712 Admiralty Way, B-101, Everett, WA 98204-5562 | 2014-10-23 |
| 1952704413 | Brad Tyson | Clinical Neuropsychologist | 12039 Ne 128th St Fl 3, Kirkland, WA 98034-3029 | 2014-09-29 |
| 1649694662 | Kelly L Crenshaw | Clinical Neuropsychologist | 12 Bellwether Way Ste 240, Bellingham, WA 98225-2959 | 2014-02-11 |
| 1508289299 | Neuropsychology and Cognitive Health | Clinical Neuropsychologist | 1808 Richards Rd #120, Bellevue, WA 98005-3982 | 2014-01-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.