Provider Demographics
NPI:1841475209
Name:GOODMAN, NATHAN W (DC)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:W
Last Name:GOODMAN
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:219 N UMPQUA ST
Mailing Address - Street 2:
Mailing Address - City:SUTHERLIN
Mailing Address - State:OR
Mailing Address - Zip Code:97479-9568
Mailing Address - Country:US
Mailing Address - Phone:541-236-8811
Mailing Address - Fax:
Practice Address - Street 1:219 N UMPQUA ST
Practice Address - Street 2:
Practice Address - City:SUTHERLIN
Practice Address - State:OR
Practice Address - Zip Code:97479-9568
Practice Address - Country:US
Practice Address - Phone:541-236-8811
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-04
Last Update Date:2025-09-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ7938111N00000X
OR3790111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor