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NPI Code Detail

MEDICARE: MRS. TERRY WOODALL R.N.

MEDICARE:  MRS. TERRY  WOODALL  R.N.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1163WS0200XSchool Registered NurseRN00076011WA

General Provider Information

NPI Number : 1275877342
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. TERRY WOODALL R.N.
Provider Business Mailing Address
First Line : 1320 178TH AVE E
Second Line :
City : LAKE TAPPS
State : WA
Zip : 98391-6411
Country : US
Telephone Number : 253-862-6600
Fax Number : 253-862-3176
Provider Business Practice Location Address
First Line : 1320 178TH AVE E
Second Line :
City : LAKE TAPPS
State : WA
Zip : 98391-6411
Country : US
Telephone Number : 253-862-6600
Fax Number : 253-862-3176
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2012
Last Update Date : 11/15/2012

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Directions to “ MRS. TERRY WOODALL R.N.” Practice Location

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