Provider Demographics
NPI:1063149953
Name:WOOD, NATALIE RAQUEL
Entity type:Individual
Prefix:MS
First Name:NATALIE
Middle Name:RAQUEL
Last Name:WOOD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5210 RUSSELL AVE NW APT 301
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98107-3999
Mailing Address - Country:US
Mailing Address - Phone:206-612-4454
Mailing Address - Fax:
Practice Address - Street 1:2366 EASTLAKE AVE E STE 402
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98102-3394
Practice Address - Country:US
Practice Address - Phone:206-202-3133
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-02
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty