Active NPI
Goodwill Industries of the Inland Northwest
- Case Management Agency
- Spokane, WA
National Provider Identifier
1871617175
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Management Agency
- 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, 2026
- Organization subpart
- No
NPPES NPI Registry
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) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003122600 | Medicaid | ID | |
| 807090100 | Medicaid | ID | |
| 807365200 | Medicaid | ID | |
| 805073000 | Medicaid | ID | |
| 003122500 | Medicaid | ID | |
| 804182600 | Medicaid | ID |
National Provider Directory
National Provider Directory- Tax ID family
- Goodwill Industries of the Inland Northwest
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Mental Health Clinic/Center (Including Community Mental Health Center)
- Spokane, WA
- NPI 1396698056
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.