Provider Demographics
NPI:1467903955
Name:WOODRUFF, BRIANNA T (ARNP)
Entity Type:Individual
Prefix:DR
First Name:BRIANNA
Middle Name:T
Last Name:WOODRUFF
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:BRIANNA
Other - Middle Name:T
Other - Last Name:MOULTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:ARNP
Mailing Address - Street 1:5410 CALIFORNIA AVE SW
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98136-1562
Mailing Address - Country:US
Mailing Address - Phone:206-486-8383
Mailing Address - Fax:206-312-8594
Practice Address - Street 1:5410 CALIFORNIA AVE SW STE 203
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98136-1562
Practice Address - Country:US
Practice Address - Phone:206-486-8383
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-10-19
Last Update Date:2024-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MTNUR-APRN-LIC-131975363LF0000X
OR201805025NP-PP363LF0000X
AK186382363LF0000X
WAAP60703574363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily