MEDICARE: SUZANNE ELLEN WOODSUM-REED MSW

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker	LW00006650	WA

General Provider Information

NPI Number	:	1861493884
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUZANNE ELLEN WOODSUM-REED MSW

Provider Business Mailing Address
First Line	:	525 LILLY RD NE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98506-5101
Country	:	US
Telephone Number	:	360-493-7230
Fax Number	:	360-493-4180

Provider Business Practice Location Address
First Line	:	525 LILLY RD NE
Second Line	:
City	:	OLYMPIA
State	:	WA
Zip	:	98506-5101
Country	:	US
Telephone Number	:	360-493-7230
Fax Number	:	360-493-4180

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	11/06/2007

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