Individual
DR. DAVID WOOTEN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
123 S MARKET BLVD, CHEHALIS, WA 98532-3037
(360) 748-9700
Mailing address
123 S MARKET BLVD, PO BOX 1245, CHEHALIS, WA 98532-3037
(360) 748-9700
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00001802
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7114812
—
WA
05
—
8298440
—
WA
Enumeration date
10/27/2005
Last updated
07/08/2007
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