1306404306 NPI number — HEATHER KATHLEEN DUNCAN GOLDY LICSW

Table of content: HEATHER KATHLEEN DUNCAN GOLDY LICSW (NPI 1306404306)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306404306 NPI number — HEATHER KATHLEEN DUNCAN GOLDY LICSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOLDY
Provider First Name:
HEATHER
Provider Middle Name:
KATHLEEN DUNCAN
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
LICSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
DUNCAN
Provider Other First Name:
HEATHER
Provider Other Middle Name:
KATHLEEN
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
MSW
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1306404306
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
06/04/2019
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
20332 166TH AVE NE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WOODINVILLE
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98072-7087
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-443-8399
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2815 EASTLAKE AVE E STE 160
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
SEATTLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98102-3194
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-782-0272
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/04/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  60555705 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





Copyright © 2007-2025 www.npivalidator.com