1497051999 NPI number — MR. JEFFERY JAMES GOFF MA, PHD

Table of content: MR. JEFFERY JAMES GOFF MA, PHD (NPI 1497051999)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1497051999 NPI number — MR. JEFFERY JAMES GOFF MA, PHD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
GOFF
Provider First Name:
JEFFERY
Provider Middle Name:
JAMES
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MA, PHD
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1497051999
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
03/13/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5108 196TH ST SW
Provider Second Line Business Mailing Address:
C/O RXDX MEDICAL BILLING SERVICES LLC, STE 310
Provider Business Mailing Address City Name:
LYNNWOOD
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98036-6169
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-976-3674
Provider Business Mailing Address Fax Number:
888-641-6642

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5108 196TH ST SW STE 350
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
LYNNWOOD
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98036-6169
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
425-582-2041
Provider Business Practice Location Address Fax Number:
425-527-0468
Provider Enumeration Date:
01/31/2011

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: 101YM0800X , with the licence number:  LH60500437 , 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)





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