Healthcare Provider Details

I. General information

NPI: 1427169838
Provider Name (Legal Business Name): JOSEPH FOLSOM WOODWARD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 04/19/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12039 NE 128TH ST STE 500
KIRKLAND WA
98034-3030
US

IV. Provider business mailing address

12039 NE 128TH ST STE 500
KIRKLAND WA
98034-3030
US

V. Phone/Fax

Practice location:
  • Phone: 425-899-1287
  • Fax:
Mailing address:
  • Phone: 425-899-1287
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2082S0105X
TaxonomySurgery of the Hand (Plastic Surgery) Physician
License NumberMD00046970
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: