CHARLES RANDALL GOODING SUDP NPI 1104577162

NPI Information

  • NPI: 1104577162
  • Provider Name: CHARLES RANDALL GOODING, SUDP
  • Classification: Counselor - 101YA0400X
  • Specialization: Addiction (Substance Use Disorder)
  • Entity Type: Individual
  • Address: 23830 PACIFIC HWY S STE 202A
    KENT, WA
    ZIP 98032
  • Phone: (206) 501-5295

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NPI Details

Charles Randall Gooding, SUDP is an addiction (substance use disorder) counselor in Kent, WA. Charles Randall Gooding, SUDP NPI is 1104577162. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

23830 PACIFIC HWY S STE 202A
KENT, WA
ZIP 98032-706
Phone: (206) 501-5295

The enumeration date for this NPI number is 1/12/2022 and was last updated on 1/12/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1101YA0400XCounselorAddiction (Substance Use Disorder)CP60474403WASHINGTONYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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