Provider Demographics
NPI:1588734362
Name:GOODSPEED, CINDY LYNN (LMP)
Entity type:Individual
Prefix:MS
First Name:CINDY
Middle Name:LYNN
Last Name:GOODSPEED
Suffix:
Gender:F
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1018 C SYLVAN WAY
Mailing Address - Street 2:
Mailing Address - City:BREMERTON
Mailing Address - State:WA
Mailing Address - Zip Code:98310-2813
Mailing Address - Country:US
Mailing Address - Phone:360-475-8226
Mailing Address - Fax:360-373-5301
Practice Address - Street 1:1018 C SYLVAN WAY
Practice Address - Street 2:
Practice Address - City:BREMERTON
Practice Address - State:WA
Practice Address - Zip Code:98310-2813
Practice Address - Country:US
Practice Address - Phone:360-475-8226
Practice Address - Fax:360-373-5301
Is Sole Proprietor?:No
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00004002225700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist