| Penny Goudelock, PA | |
|
1100 Pacific Ave, Suite 202, Everett, WA 98201-4261 | |
| (425) 388-4075 | |
| Not Available |
| Full Name | Penny Goudelock |
|---|---|
| Gender | Female |
| Speciality | Physician Assistant - Medical |
| Location | 1100 Pacific Ave, Everett, Washington |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043433352 | NPI | - | NPPES |
| 8485898 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363AM0700X | Physician Assistant - Medical | PA10005160 (Washington) | Primary |
| Entity Name | American Current Care of Washington PS |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1073096871 PECOS PAC ID: 8022356617 Enrollment ID: O20190206000846 |
| Mailing Address | Practice Location Address |
|---|---|
| Penny Goudelock, PA 18012 W Valley Hwy, Ste 101, Kent, WA 98032-2924 Ph: (425) 291-3300 | Penny Goudelock, PA 1100 Pacific Ave, Suite 202, Everett, WA 98201-4261 Ph: (425) 388-4075 |
Tina Malm, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 2205 Broadway, Everett, WA 98201 Phone: 888-227-3312 Fax: 425-259-8630 |
Mr. James Potocsnak, PAC Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 2320 Rucker Ave, Everett, WA 98201 Phone: 425-259-5121 Fax: 425-252-1322 |
Michael James Oliver, Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3726 Broadway Ste 201, Everett, WA 98201 Phone: 425-317-9119 |
Karen M Tooley, PA-C Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 1330 Rockefeller Ave, Suite 400, Everett, WA 98201 Phone: 425-261-4950 |
Mary E Mitchell, PA Physician Assistant Medicare: Accepting Medicare Assignments Practice Location: 3927 Rucker Ave, Everett, WA 98201 Phone: 425-339-5422 Fax: 425-303-3053 |
Gary K. Baal, PA-C Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 1321 Colby Ave, Everett, WA 98201 Phone: 425-261-2000 |
Travis B. Adelman, P.A. Physician Assistant Medicare: Not Enrolled in Medicare Practice Location: 4201 Rucker Ave, Everett, WA 98203 Phone: 425-382-4000 |