Provider Demographics
NPI:1316405673
Name:WOOD, BARBARA A (PA-C)
Entity Type:Individual
Prefix:
First Name:BARBARA
Middle Name:A
Last Name:WOOD
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:BARBARA
Other - Middle Name:A
Other - Last Name:TILFORD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3810 KERN WAY STE B
Mailing Address - Street 2:
Mailing Address - City:YAKIMA
Mailing Address - State:WA
Mailing Address - Zip Code:98902-7805
Mailing Address - Country:US
Mailing Address - Phone:509-228-7237
Mailing Address - Fax:844-315-7388
Practice Address - Street 1:3810 KERN WAY STE B
Practice Address - Street 2:
Practice Address - City:YAKIMA
Practice Address - State:WA
Practice Address - Zip Code:98902-7805
Practice Address - Country:US
Practice Address - Phone:509-228-7237
Practice Address - Fax:844-315-7388
Is Sole Proprietor?:No
Enumeration Date:2019-03-06
Last Update Date:2020-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA60965362207Q00000X, 363AM0700X
390200000X
WAOA61015214363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA2141812Medicaid