Active NPI
Brooklyn P Goudreau, PA-C
- Physician Assistant
- Snohomish, WA
National Provider Identifier
1497388011
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- Practice address
- 8102 151St PL SE
Snohomish, WA 98296-7708 - Phone
- (425) 518-2956
- NPI assigned
- Feb 21, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | Primary |
Addresses
Primary practice location
8102 151St PL SE
Snohomish, WA 98296-7708
Mailing address
8102 151St PL SE
Snohomish, WA 98296-7708
Other practice location 1
630 N Fairview Dr
Tacoma, WA 98406-1015
Phone (253) 777-1423
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in WA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Other, 2019
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
Tacoma, WA 98406
Phone (253) 777-1423
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Physician Assistant
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Internal Medicine Physician
- University Place, WA
- NPI 1861145120
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1582243200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1773273600000",
"number": "1497388011",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "8102 151ST PL SE",
"city": "SNOHOMISH",
"state": "WA",
"postal_code": "982967708"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "8102 151ST PL SE",
"city": "SNOHOMISH",
"state": "WA",
"postal_code": "982967708",
"telephone_number": "425-518-2956"
}
],
"practiceLocations": [
{
"address_1": "630 N Fairview Dr",
"address_purpose": "LOCATION",
"city": "Tacoma",
"state": "WA",
"postal_code": "984061015",
"country_code": "US",
"telephone_number": "253-777-1423",
"fax_number": "206-673-8050",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "GOUDREAU",
"first_name": "BROOKLYN",
"middle_name": "P",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-02-21",
"last_updated": "2026-03-12",
"certification_date": "2026-03-12",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Snohomish, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.