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General NPI Number Information
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NPI Number | 1770416414
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Entity Type | Individual
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Provider Name | BRETT WOODS
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Gender | Male
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Dates
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Enumeration Date | 06/03/2026
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Last Update Date | 06/03/2026
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Provider Practice Location Address
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Address Line | 3455 REWAK DR STE 106
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City | FAIRBANKS
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State | AK
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Zip | 99709-5024
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Country | US
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Telephone | 907-457-5322
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Fax |
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Provider Business Mailing Address
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Address Line | 3410 NE 54TH ST
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City | VANCOUVER
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State | WA
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Zip | 98661-2025
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Country | US
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Telephone |
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 248019
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License Number State | WA
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