Provider Demographics
NPI:1720659485
Name:GOODWIN, ALYSHA (MSN, FNP-C, ARNP)
Entity type:Individual
Prefix:
First Name:ALYSHA
Middle Name:
Last Name:GOODWIN
Suffix:
Gender:
Credentials:MSN, FNP-C, ARNP
Other - Prefix:
Other - First Name:ALYSHA
Other - Middle Name:
Other - Last Name:BUTTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4610 NW UTAH CT
Mailing Address - Street 2:
Mailing Address - City:CAMAS
Mailing Address - State:WA
Mailing Address - Zip Code:98607-9129
Mailing Address - Country:US
Mailing Address - Phone:702-526-6657
Mailing Address - Fax:
Practice Address - Street 1:5400 MACARTHUR BLVD
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98661-7049
Practice Address - Country:US
Practice Address - Phone:360-696-5100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-05
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61191002363L00000X
OR10001515363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily