MR. KEVIN ADAM GOODELL (NPI# 1952588725) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1952588725 |
| Entity Type | Individual |
| Full Name | MR. KEVIN ADAM GOODELL |
| Credential | PA |
| Practice Address |
505 S 336th St Ste 500 Federal Way WA 98003-8300 |
| Mailing Address |
3420 Illinois St Great Lakes IL 60088-3120 |
| Practice Telephone | 2069623535 |
| Mailing Telephone | 8476882251 |
| Enumeration Date | 2008-01-23 |
| Last Update Date | 2019-10-29 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3420 Illinois St, Great Lakes, IL 600883120 | 8476886755 |
| Street Address |
505 S 336TH ST STE 500 |
| City | FEDERAL WAY |
| State | WA |
| Zip Code | 98003-8300 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1346228301 | Mary Elsbeth Johann | Nurse Practitioner | 505 S 336th St Ste 500, Federal Way, WA 98003-8300 | 2006-01-09 |
| 1356864631 | Eleanor Pascual | Registered Nurse | 505 S 336th St Ste 500, Federal Way, WA 98003-8300 | 2017-07-19 |
| 1578015517 | Mohsin Ikram | Nurse Practitioner | 505 S 336th St Ste 500, Federal Way, WA 98003-8300 | 2016-10-25 |
| 1376905463 | Mayuree Rao | Internal Medicine | 505 S 336th St Ste 500, Federal Way, WA 98003-8300 | 2016-03-28 |
| 1700272572 | Wendelyn Shue | Family Medicine | 505 S 336th St Ste 500, Federal Way, WA 98003-8300 | 2015-04-08 |
| 1003207655 | Veronica Linn | Nurse Practitioner | 505 S 336th St Ste 500, Federal Way, WA 98003-8300 | 2015-02-17 |
| 1417350232 | Bobbi Woodward | Nurse Practitioner | 505 S 336th St Ste 500, Federal Way, WA 98003-8300 | 2014-10-07 |
| 1407258783 | Joseph A Sutton | Physician Assistant | 505 S 336th St Ste 500, Federal Way, WA 98003-8300 | 2014-09-18 |
| 1275935553 | Rose Jones | Physician Assistant | 505 S 336th St Ste 500, Federal Way, WA 98003-8300 | 2014-09-18 |
| 1356755862 | Scott Bogdanoff | Nurse Practitioner | 505 S 336th St Ste 500, Federal Way, WA 98003-8300 | 2014-06-12 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124634969 | Jossie Jeniffer Wong-vicuna | Interpreter | 3001 S 288th Street, 201, Ferderal Way, WA 98003 | 2020-09-17 |
| 1336642420 | Otto Family | Massage Therapist | 720 S 348th St Ste A-1b, Federal Way, WA 98003 | 2018-03-14 |
| 1962912709 | Lindsay Plumley | Occupational Therapist | 33330 8th Avenue S, Federal Way, WA 98003 | 2017-10-06 |
| 1861922387 | Sea Mar Community Health Centers | Pharmacy | 31405 18th Ave South, Federal Way, WA 98003 | 2017-06-18 |
| 1023547072 | Iora Health Washington Physicians, P.C. | Internal Medicine | 1414 S. 324th Street, Federal Way, WA 98003 | 2017-06-05 |
| 1811346869 | Iora Senior Health Inc | Internal Medicine | 1414 S 324th St, Federal Way, WA 98003 | 2016-06-10 |
| 1972958940 | Kathy Marie Haviland | Registered Nurse | 1010 S. 336th St, Supplemental Health Care, Federal Way, WA 98003 | 2016-04-27 |
| 1972969343 | Jacklyn Marie James | Specialist | 530 South 336th Street, Ste C, Massage for Health and Day Spa, Inc., Federal Way, WA 98003 | 2016-01-14 |
| 1659767036 | Jillian Liner | Pediatrics | 34503 9th Ave S Ste 220, Federal Way, WA 98003 | 2015-04-12 |
| 1235537739 | Simranjit Singh Longia | Student in an Organized Health Care Education/Training Program | 34618 11th Ave. S., Suite 100, Federal Way, WA 98003 | 2014-12-15 |
| Find all providers in zip 98003 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982840526 | Sara Jagels Wagner | Physician Assistant | 700 S 320th St Ste A, Federal Way, WA 98003-4691 | 2009-01-04 |
| 1942226352 | Kelly A. Zessin | Physician Assistant | 31675 Pacific Hwy S, Federal Way, WA 98003 | 2006-07-15 |
| 1053809277 | Jessica Ann Sisu | Physician Assistant | 30809 1st Ave S, Federal Way, WA 98003-4074 | 2018-04-24 |
| 1902275233 | Ismail Jatta | Physician Assistant | 33501 1st Way S, Federal Way, WA 98003-6208 | 2015-09-16 |
| 1497137889 | Christopher Pratt | Physician Assistant | 33501 1st Way S, Ms:a-so, Federal Way, WA 98003-6208 | 2015-06-23 |
| 1275935553 | Rose Jones | Physician Assistant | 505 S 336th St Ste 500, Federal Way, WA 98003-8300 | 2014-09-18 |
| 1548683295 | Carina Walker | Physician Assistant | 33501 1st Way S, Federal Way, WA 98003-6208 | 2014-01-31 |
| 1780968883 | Elizabeth Kathleen Shuckhart | Physician Assistant | 301 S 320th St, Federal Way, WA 98003-5200 | 2011-10-06 |
| 1790973923 | Aaron Louis Isaac | Physician Assistant | 34515 9th Ave S, Federal Way, WA 98003-6761 | 2007-10-12 |
| 1467509653 | Rick I. Eskenazi | Physician Assistant | 301 S 320th St, Federal Way, WA 98003-5200 | 2007-01-03 |
| Find all providers in FEDERAL WAY | ||||
| City | FEDERAL WAY |
| Zip Code | 98003 |
Please comment or provide details below to improve the information on MR. KEVIN ADAM GOODELL.
| 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.