MEDICARE: DANIELLE MARIE WOODWORTH

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
1	225XH1200X	Hand Occupational Therapist	14214	CA
2	225X00000X	Occupational Therapist	OT60841070	WA

General Provider Information

NPI Number	:	1356690481
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DANIELLE MARIE WOODWORTH

Provider Business Mailing Address
First Line	:	1200 CORPORATE DR STE 400
Second Line	:
City	:	HOOVER
State	:	AL
Zip	:	35242-5424
Country	:	US
Telephone Number	:	423-702-4389
Fax Number	:

Provider Business Practice Location Address
First Line	:	4411 POINT FOSDICK DR STE 101
Second Line	:
City	:	GIG HARBOR
State	:	WA
Zip	:	98335-1703
Country	:	US
Telephone Number	:	253-851-7472
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/05/2012
Last Update Date	:	02/11/2026

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