Provider Demographics
NPI:1154841575
Name:WOOD, JULIA A (AUD, CCC-A)
Entity type:Individual
Prefix:DR
First Name:JULIA
Middle Name:A
Last Name:WOOD
Suffix:
Gender:F
Credentials:AUD, CCC-A
Other - Prefix:DR
Other - First Name:JULIA
Other - Middle Name:A
Other - Last Name:GODDEERIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:AUD, CCC-A
Mailing Address - Street 1:510 8TH AVE NE STE 310
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98029-5436
Mailing Address - Country:US
Mailing Address - Phone:425-454-3938
Mailing Address - Fax:425-392-3561
Practice Address - Street 1:510 8TH AVE NE STE 310
Practice Address - Street 2:
Practice Address - City:ISSAQUAH
Practice Address - State:WA
Practice Address - Zip Code:98029-5436
Practice Address - Country:US
Practice Address - Phone:425-454-3938
Practice Address - Fax:425-392-3561
Is Sole Proprietor?:No
Enumeration Date:2017-06-27
Last Update Date:2022-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD61095114231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ032920Medicaid
TN1154841575OtherNPI