Healthcare Provider Details

I. General information

NPI: 1013610005
Provider Name (Legal Business Name): JOSEPH ROBERT WOOD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/27/2023
Last Update Date: 07/21/2026
Certification Date: 07/21/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

907 GEORGIANA ST
PORT ANGELES WA
98362-3911
US

IV. Provider business mailing address

PO BOX 24029
SEATTLE WA
98124-0029
US

V. Phone/Fax

Practice location:
  • Phone: 360-565-0999
  • Fax:
Mailing address:
  • Phone: 360-565-0999
  • Fax: 360-565-7654

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD.MD.61690830
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: