Tri Cities Pain Conference Registration Form 26: Submission #1544
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Submission information
Submission Number: 1544
Submission ID: 4471
Submission UUID: aa99417b-d6ce-45be-9b99-13d702cb04a0
Submission URI: /tripain26/form
Created: Wed, 01/07/2026 - 06:37
Completed: Wed, 01/07/2026 - 06:37
Changed: Wed, 01/07/2026 - 06:37
Remote IP address: 192.88.134.7
Submitted by: Anonymous
Language: English
Is draft: No
Current page: Complete
Webform: Paid/Free Conference Registration
Submitted to: Tri Cities Pain Conference Registration Form 26
| First Name | christopher |
|---|---|
| Last Name | godbout |
| cjgodbout@yahoo.com | |
| Degree | M.D. |
| Specialty | Interventional Pain Management |
| Clinic/Organization | MultiCare Health System |
| Conference Format | |
| Address | 10625 Marine View Dr SW, Seattle WA 98146-1672 |
| City | Seattle |
| State | WA |
| Zip | 98146-1672 |
| Phone | 9194141139 |
| Payment | Card payment |
| Conference type | Complete Conference |
| Thursday | |
| Friday | Virtual |
| Saturday | Virtual |
| Notes | |
| anet_transaction_reference | ref1767767850 |
| anet_payment_status | pending |
| Ammount | 451.52 |
| Registration code | tripain26 |
| Title | Tri Cities Pain Conference 26 |
| Receipt | Receipt |
| Payment Note | RussoCME 935 SE High St Pullman, WA 99163 |
| Invoice number | tripain26_1767767834 |
| Tax | 36.52 |
| Base amount | 415 |
| Taxed Amount | 415 |
| Total Days | 2 |
| Recording Days | 0 |
| Non Recording Days | 2 |
| Per Day Amount | 207.5 |
| Tax Percentage | 8.8 |