Provider Demographics
NPI:1124339585
Name:WOODS, DAWN A (ARNP)
Entity type:Individual
Prefix:
First Name:DAWN
Middle Name:A
Last Name:WOODS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3002
Mailing Address - Street 2:
Mailing Address - City:LONGVIEW
Mailing Address - State:WA
Mailing Address - Zip Code:98632-0302
Mailing Address - Country:US
Mailing Address - Phone:360-636-6900
Mailing Address - Fax:360-636-2336
Practice Address - Street 1:812 OCEAN BEACH HWY STE 200
Practice Address - Street 2:
Practice Address - City:LONGVIEW
Practice Address - State:WA
Practice Address - Zip Code:98632-4082
Practice Address - Country:US
Practice Address - Phone:360-636-6900
Practice Address - Fax:360-636-2336
Is Sole Proprietor?:No
Enumeration Date:2010-06-30
Last Update Date:2010-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP60154837363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0266517OtherLABOR & INDUSTRIES
WA2008684Medicaid
OR500627109Medicaid
WAG8894854Medicare PIN