Provider Demographics
NPI:1477978187
Name:WOODY, ALAN LEE ((ARRT) (R) (CT))
Entity Type:Individual
Prefix:MR
First Name:ALAN
Middle Name:LEE
Last Name:WOODY
Suffix:
Gender:M
Credentials:(ARRT) (R) (CT)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 RENTON AVE S
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98057-6061
Mailing Address - Country:US
Mailing Address - Phone:360-593-9184
Mailing Address - Fax:
Practice Address - Street 1:701 RENTON AVE S
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98057-6061
Practice Address - Country:US
Practice Address - Phone:360-593-9184
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-03-04
Last Update Date:2014-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA3818182471C3401X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2471C3401XTechnologists, Technicians & Other Technical Service ProvidersRadiologic TechnologistComputed Tomography