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General NPI Number Information
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NPI Number | 1336959964
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Entity Type | Individual
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Provider Name | JOHN GALLOWAY WOODGATE
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Gender | Male
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Dates
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Enumeration Date | 01/07/2025
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Last Update Date | 08/20/2025
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Provider Practice Location Address
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Address Line | 6306 215TH ST SW STE 3
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City | MOUNTLAKE TERRACE
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State | WA
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Zip | 98043-6025
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Country | US
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Telephone | 425-224-6255
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Fax |
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Provider Business Mailing Address
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Address Line | 21236 NE 12TH ST
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City | SAMMAMISH
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State | WA
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Zip | 98074-6740
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Country | US
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Telephone | 425-503-9641
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106S00000X
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Taxonomy Name | Behavior Technician
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License Number |
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License Number State |
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