Healthcare Provider Details

I. General information

NPI: 1770570160
Provider Name (Legal Business Name): ALAN STUART WOODLE DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/30/2005
Last Update Date: 06/07/2011
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8111 GREENWOOD AVE N
SEATTLE WA
98103-4230
US

IV. Provider business mailing address

8111 GREENWOOD AVE N
SEATTLE WA
98103-4230
US

V. Phone/Fax

Practice location:
  • Phone: 206-784-3144
  • Fax: 206-784-4956
Mailing address:
  • Phone: 206-784-3144
  • Fax: 206-784-4956

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number276
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: