Individual
NATHANAEL WOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
11315 BRIDGEPORT WAY SW, LAKEWOOD, WA 98499-3004
(253) 859-8700
(360) 738-6377
Mailing address
505 S 336TH ST, SUITE 600, FEDERAL WAY, WA 98003-6328
(253) 838-6180
(253) 838-6418
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
PENDING
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0222712
LIWA
WA
01
—
0222713
LIWA
WA
01
—
0222714
LIWA
WA
01
—
1131WO
BSWA
WA
01
—
8119WO
BSWA
WA
05
—
8488124
—
WA
Enumeration date
05/29/2007
Last updated
02/19/2008
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