Provider Demographics
NPI:1124579800
Name:WOODS, MARCUS
Entity Type:Individual
Prefix:
First Name:MARCUS
Middle Name:
Last Name:WOODS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:MARCUS
Other - Middle Name:JAMES
Other - Last Name:NEAL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:18531 FREMONT AVE N
Mailing Address - Street 2:UNIT B
Mailing Address - City:SHORELINE
Mailing Address - State:WA
Mailing Address - Zip Code:98133-3820
Mailing Address - Country:US
Mailing Address - Phone:206-290-9732
Mailing Address - Fax:206-566-6913
Practice Address - Street 1:10015 LAKE CITY WAY NE STE 441
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-7770
Practice Address - Country:US
Practice Address - Phone:206-290-9732
Practice Address - Fax:206-566-6913
Is Sole Proprietor?:Yes
Enumeration Date:2016-10-18
Last Update Date:2016-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA60686169101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor