Provider Demographics
NPI:1366467151
Name:GOODHUE, CLAY JUSTIN (CFA)
Entity type:Individual
Prefix:
First Name:CLAY
Middle Name:JUSTIN
Last Name:GOODHUE
Suffix:
Gender:M
Credentials:CFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 270828
Mailing Address - Street 2:
Mailing Address - City:LITTLETON
Mailing Address - State:CO
Mailing Address - Zip Code:80127-0014
Mailing Address - Country:US
Mailing Address - Phone:720-937-8412
Mailing Address - Fax:720-981-1588
Practice Address - Street 1:10607 W COOPER DR
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80127-2984
Practice Address - Country:US
Practice Address - Phone:720-937-8412
Practice Address - Fax:720-981-1588
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2012-01-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZS0410XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Technologist