PENNY GOUDELOCK PA
NPI 1043433352
Physician Assistant - Medical in Everett, WA
NPI Status: Active since April 11, 2007
Contact Information
1100 PACIFIC AVE
SUITE 202
EVERETT, WA
ZIP 98201
Phone: (425) 388-4075
- Individual
- Female
- Physician Assistant
- Medical
- Accepts Insurance
- PECOS Enrolled
About PENNY GOUDELOCK
This page provides the complete NPI Profile along with additional information for Penny Goudelock, a primary care provider established in Everett, Washington with a medical specialization in Physician Assistant, focusing in medical . The healthcare provider is registered in the NPI registry with number 1043433352 assigned on April 2007. The practitioner's primary taxonomy code is 363AM0700X with license number PA10005160 (WA). The provider is registered as an individual and her NPI record was last updated 5 years ago.
- NPI
- 1043433352
- Provider Name
- PENNY GOUDELOCK PA
- Gender
- Female
- Entity Type
- Individual
- Location Address
- 1100 PACIFIC AVE SUITE 202 EVERETT, WA 98201
- Location Phone
- (425) 388-4075
- Mailing Address
- 18012 W VALLEY HWY STE 101 KENT, WA 98032
- Mailing Phone
- (425) 291-3300
- Mailing Fax
- Is Sole Proprietor?
- No
- Enumeration Date
- 04-11-2007
- Last Update Date
- 04-14-2020
- Code Navigator
A primary care provider (PCP) like Penny Goudelock sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Physician Assistant Medical
- Taxonomy Code
- 363AM0700X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- License No.
- PA10005160
- License State
- WA
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Navigator Bronze 7000 Exchange - PPO
- Navigator Bronze 9200 - PPO
- Navigator Bronze HSA 8050 - PPO
- Navigator Gold 1500 - PPO
- Navigator Gold 1500 Exchange - PPO
- Navigator Gold 500 Exchange - PPO
- Navigator Silver 3500 Exchange - PPO
- Navigator Silver 4000 Exchange - PPO
- Navigator Silver 5000 - PPO
- Navigator Silver HSA 3500 - PPO
- Navigator Standard Expanded Bronze - PPO
- Navigator Standard Gold - PPO
- Navigator Standard Silver - PPO
- PacificSource Oregon Standard Bronze Plan NAV - PPO
- PacificSource Oregon Standard Gold Plan NAV - PPO
- PacificSource Oregon Standard Silver Plan NAV - PPO
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 8485898 | MEDICAID (05) | WA |
Medicare Participation & PECOS Enrollment Status
Penny Goudelock is enrolled in PECOS and is eligible to order or refer health care services for Medicare patients. The provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
What is PECOS?
PECOS is the online Medicare enrollment management system or Provider, Enrollment, Chain and Ownership System. The PECOS system is a database of providers who have registered with CMS as providers or suppliers. PECOS is the primary source of information about verified Medicare professionals. Providers that want to participate in this program need to enroll in PECOS with their NPI number to avoid denied claims.
Is the provider registered in PECOS? Yes
Eligible to Order or Refer Part B Clinical Laboratory and Imaging: Yes
Eligible to Order or Refer Durable Medical Equipment (DMEPOS): Yes
Eligible to Order or Refer a Home Health Agency (HHA): Yes
Eligible to Order or Refer Power Mobility Devices: Yes
Areas of Expertise
The following services and procedures, recently provided to Medicare patients, illustrate the range of care this provider offers. This list reflects the variety of services available to all patients visiting the practice and is based on 2022 Medicare dataset. In general, the more frequently a provider treats specific conditions or performs particular procedures, the more experienced they become in addressing similar patient needs. The provider has delivered many of the services listed below to Medicare patients. Please note that this list does not include services provided to patients who are not covered by Medicare.
New patient office or other outpatient visit, 30-44 minutes
This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.
This service was performed 19 times for 19 patientsReviews for PENNY GOUDELOCK PA
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 0 | 4 | 3 | 4 | 3 | 3 | 3 | 5 | 2 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 0 | 8 | 3 | 8 | 3 | 6 | 3 | 10 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 0 + 8 + 3 + 8 + 3 + 6 + 3 + 1 + 0 + 24 = 58 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 60 - 58 = 2 | 2 | ||||||||
The NPI number 1043433352 is valid because the calculated check digit 2 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following 20 providers are registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1073503181 | DR. ROXANNE E HERTZOG M.D. Individual | Anesthesiology | 1100 PACIFIC AVE SUITE 100 EVERETT, WA 98201 (206) 244-1212 |
| 1750371878 | DR. MICHAEL HOM M.D. Individual | Anesthesiology | 1100 PACIFIC AVE SUITE 100 EVERETT, WA 98201 (206) 244-1212 |
| 1831180884 | DR. MICHAEL FLACCO M.D. Individual | Anesthesiology | 1100 PACIFIC AVE SUITE 100 EVERETT, WA 98201 (206) 244-1212 |
| 1013986488 | DR. PETER J. KINAHAN M.D. Individual | Orthopaedic Surgery | 1100 PACIFIC AVE SUITE 300 EVERETT, WA 98201 (425) 339-2433 |
| 1164491429 | DR. RALPH T. HALLER M.D. Individual | Orthopaedic Surgery | 1100 PACIFIC AVE SUITE 300 EVERETT, WA 98201 (725) 339-2433 |
| 1588625800 | DR. CLAY M WERTHEIMER M.D. Individual | Orthopaedic Surgery | 1100 PACIFIC AVE SUITE 300 EVERETT, WA 98201 (425) 339-2433 |
| 1356361588 | DR. BILL K HUANG M.D. Individual | Orthopaedic Surgery | 1100 PACIFIC AVE SUITE 300 EVERETT, WA 98201 (425) 339-2433 |
| 1003945643 | DR. RICHARD L SEMON MD Individual | Orthopaedic Surgery | 1100 PACIFIC AVE SUITE 300 EVERETT, WA 98201 (425) 339-2433 |
| 1922132646 | MS. CHRISTINE L HAYES RNFA Individual | Registered Nurse (Medical-Surgical) | 1100 PACIFIC AVE SUITE 300 EVERETT, WA 98201 (425) 339-2433 |
| 1801001805 | DR. ALEX H KANG D.D.S., M.S.D. Individual | Dentist (Prosthodontics) | 1100 PACIFIC AVE SUITE 200 EVERETT, WA 98201 (425) 258-3130 |
| 1003082017 | DR. JOHN D PRYOR M.D. Individual | Orthopaedic Surgery | 1100 PACIFIC AVE SUITE 300 EVERETT, WA 98201 (425) 339-2433 |
| 1083871305 | DR. DOUGLAS D NOWAK M.D. Individual | Orthopaedic Surgery | 1100 PACIFIC AVE SUITE 300 EVERETT, WA 98201 (425) 339-2433 |
| 1073847240 | MONO NHEAN OT Individual | Occupational Therapist | 1100 PACIFIC AVE SUITE 201 EVERETT, WA 98201 (425) 374-2846 |
| 1174592588 | DR. JEFF R MASON M.D. Individual | Orthopaedic Surgery | 1100 PACIFIC AVE SUITE 300 EVERETT, WA 98201 (425) 339-2433 |
| 1114998168 | DR. HOWARD BARNUM BARKER MD Individual | Orthopaedic Surgery | 1100 PACIFIC AVE SUITE 300 EVERETT, WA 98201 (425) 339-2433 |
| 1659751949 | MELISSA ANN MORRIS RN, CNOR, RNFA Individual | Registered Nurse | 1100 PACIFIC AVE SUITE 300 EVERETT, WA 98201 (425) 339-2433 |
| 1538264296 | MR. CRISPIN S WILHELM M.D. Individual | Psychiatry & Neurology (Neurology) | 1100 PACIFIC AVE SUITE 300 EVERETT, WA 98201 (425) 339-2433 |
| 1659340289 | DR. TODD W. HAVENER M.D. Individual | Orthopaedic Surgery (Hand Surgery) | 1100 PACIFIC AVE SUITE 300 EVERETT, WA 98201 (425) 339-2433 |
| 1659458149 | OUTPATIENT ANESTHESIA SERVICES, PLLC Organization | Anesthesiology | 1100 PACIFIC AVE SUITE 100 EVERETT, WA 98201 (425) 339-2433 |
| 1336791698 | MARIA GARSI LAT, ATC Individual | Specialist/Technologist (Athletic Trainer) | 1100 PACIFIC AVE EVERETT, WA 98201 (425) 339-2433 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1043433352, enumerated in the NPI registry as an "individual" on April 11, 2007
The provider is located at 1100 Pacific Ave Suite 202 Everett, Wa 98201 and the phone number is (425) 388-4075
The provider's speciality is Physician Assistant with taxonomy code 363AM0700X with a focus in Medical
The provider might be accepting Accepts: PacificSource Health Plans, Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
Yes, as of June 20, 2025 the provider is registered in PECOS and is eligible to order health care services or supplies for Medicare patients. If you are a beneficiary the provider is eligible to order or refer: Part B Clinical Laboratory and Imaging, Durable Medical Equipment (DME), a Home Health Agency (HHA) and Power Mobility Devices.
The most common procedures or services performed by this practitioner are: New patient office or other outpatient visit, 30-44 minutes.
This NPI record was last updated on April 11, 2007. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.