Organization Active NPI

Goodwill Industries of the Inland Northwest

  • Case Management Agency
  • Spokane, WA
National Provider Identifier
1871617175
Registry record updated Aug 6, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management AgencyTaxonomy code 251B00000X
Legal business name
GOODWILL INDUSTRIES OF THE INLAND NORTHWEST
Practice address
130 E 3Rd Ave
Spokane, WA 99202-1410
Phone
(509) 838-4246
Fax
(509) 444-4371
NPI assigned
Mar 19, 2007
Last updated
Aug 6, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 6, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mr. Clark Montgomery Brekke
Title
President/Ceo/Executive Office
Phone
(509) 444-4381

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Agency 251B00000X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Community/Behavioral Health Agency 251S00000X

Addresses

Primary practice location

130 E 3Rd Ave
Spokane, WA 99202-1410

Mailing address

130 E 3Rd Ave
Spokane, WA 99202-1410
Phone (509) 838-4246

Other identifiers 6

IdentifierTypeStateIssuer
003122600MedicaidID
807090100MedicaidID
807365200MedicaidID
805073000MedicaidID
003122500MedicaidID
804182600MedicaidID

National Provider Directory

National Provider Directory
Tax ID family
Goodwill Industries of the Inland Northwest2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Locations

789 N Central Dr
Moses Lake, WA 98837

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1174262400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1785974400000",
    "number": "1871617175",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "130 E 3RD AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021410",
            "telephone_number": "509-838-4246",
            "fax_number": "509-444-4371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "130 E 3RD AVE",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992021410",
            "telephone_number": "509-838-4246",
            "fax_number": "509-444-4371"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GOODWILL INDUSTRIES OF THE INLAND NORTHWEST",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-19",
        "last_updated": "2026-08-06",
        "certification_date": "2026-08-06",
        "status": "A",
        "authorized_official_last_name": "BREKKE",
        "authorized_official_first_name": "CLARK",
        "authorized_official_middle_name": "MONTGOMERY",
        "authorized_official_title_or_position": "PRESIDENT/CEO/EXECUTIVE OFFICE",
        "authorized_official_telephone_number": "509-444-4381",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251B00000X",
            "taxonomy_group": "",
            "desc": "Case Management",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003122600",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807090100",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "807365200",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "805073000",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003122500",
            "state": "ID"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "804182600",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 6, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.