Healthcare Provider Details

I. General information

NPI: 1609333749
Provider Name (Legal Business Name): HANNAH WOOD MA60890902
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HANNAH GILBERT MA60890902

II. Dates (important events)

Enumeration Date: 02/25/2019
Last Update Date: 02/25/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3561 NW ANDERSON HILL RD
SILVERDALE WA
98383-9130
US

IV. Provider business mailing address

1207 NW TAHOE LN APT 303
SILVERDALE WA
98383-7922
US

V. Phone/Fax

Practice location:
  • Phone: 360-692-4264
  • Fax:
Mailing address:
  • Phone: 804-929-3536
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225700000X
TaxonomyMassage Therapist
License NumberMA60890902
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: