Individual
MARYANN K WOODFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA C
Contact information
Practice address
13451 SE 36TH ST, BELLEVUE, WA 98006-1475
(425) 562-1337
Mailing address
13451 SE 36TH ST, BELLEVUE, WA 98006-1475
(425) 562-1337
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA10003952
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8372740
—
WA
Enumeration date
09/01/2006
Last updated
05/11/2021
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