Provider Demographics
NPI:1639386022
Name:WOODS, DONALD R (PHD)
Entity Type:Individual
Prefix:DR
First Name:DONALD
Middle Name:R
Last Name:WOODS
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 87027
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98687-7027
Mailing Address - Country:US
Mailing Address - Phone:360-213-0077
Mailing Address - Fax:360-892-4556
Practice Address - Street 1:305 NE 192ND AVE
Practice Address - Street 2:
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98684-7524
Practice Address - Country:US
Practice Address - Phone:360-213-0077
Practice Address - Fax:360-892-4556
Is Sole Proprietor?:No
Enumeration Date:2007-05-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPY00002945103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical