MEDICARE: TODD BARRETT WOODS PA-C

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	363A00000X	Physician Assistant	60197708	WA

General Provider Information

NPI Number	:	1932408267
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD BARRETT WOODS PA-C

Provider Business Mailing Address
First Line	:	4210 4TH AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-6514
Country	:	US
Telephone Number	:	206-860-4929
Fax Number	:

Provider Business Practice Location Address
First Line	:	4210 4TH AVE NE
Second Line	:
City	:	SEATTLE
State	:	WA
Zip	:	98105-6514
Country	:	US
Telephone Number	:	206-498-9201
Fax Number	:

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

Provider Enumeration Date	:	03/25/2011
Last Update Date	:	03/25/2011

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