Provider Demographics
NPI:1144779794
Name:GOODWIN, LUCAS (PHD)
Entity type:Individual
Prefix:MR
First Name:LUCAS
Middle Name:
Last Name:GOODWIN
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:688 CHUCKANUT HEIGHTS RD
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98229-8988
Mailing Address - Country:US
Mailing Address - Phone:646-331-4262
Mailing Address - Fax:
Practice Address - Street 1:119 N COMMERCIAL ST STE 415
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-4437
Practice Address - Country:US
Practice Address - Phone:360-712-3154
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-09-23
Last Update Date:2025-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61663117103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical