Individual provider · Type 1 NPI

Penny Goudelock, PA

Medical Physician Assistant · Everett, WA

NPI number 1043433352 Active

Practice location

1100 Pacific Ave, Suite 202
Everett, WA 98201-4261

Mailing address

18012 W Valley Hwy, Ste 101
Kent, WA 98032-2924

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant Primary 363AM0700XPA10005160 (WA)

Medical Physician Assistant: Definition to come...

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About NPI 1043433352

Penny Goudelock, PA's National Provider Identifier is 1043433352, issued on Apr 11, 2007. The primary taxonomy on file is Medical Physician Assistant (363AM0700X), and the practice location is in Everett, WA. The record was last updated on Apr 14, 2020.