Provider Demographics
NPI:1528345634
Name:WOODS, KATHERINE MARIE (ATC, LAT, WEMT)
Entity type:Individual
Prefix:MS
First Name:KATHERINE
Middle Name:MARIE
Last Name:WOODS
Suffix:
Gender:F
Credentials:ATC, LAT, WEMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1720 S 200 E
Mailing Address - Street 2:
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84115-1915
Mailing Address - Country:US
Mailing Address - Phone:304-389-1293
Mailing Address - Fax:
Practice Address - Street 1:1850 E 250 S
Practice Address - Street 2:HPER E RM 207
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84112
Practice Address - Country:US
Practice Address - Phone:801-585-9070
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2011-11-03
Last Update Date:2016-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
146N00000X
UT7454602-48102255A2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic