Provider Demographics
NPI:1790386381
Name:WOODS, MARIA MAGDALENA SERAFIN
Entity Type:Individual
Prefix:
First Name:MARIA MAGDALENA
Middle Name:SERAFIN
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:MARIA MAGDALENA
Other - Middle Name:SERAFIN
Other - Last Name:STALEY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2108 71ST ST NE
Mailing Address - Street 2:
Mailing Address - City:TULALIP
Mailing Address - State:WA
Mailing Address - Zip Code:98271-9119
Mailing Address - Country:US
Mailing Address - Phone:360-651-8672
Mailing Address - Fax:425-963-2256
Practice Address - Street 1:2108 71ST ST NE
Practice Address - Street 2:
Practice Address - City:TULALIP
Practice Address - State:WA
Practice Address - Zip Code:98271-9119
Practice Address - Country:US
Practice Address - Phone:360-651-8672
Practice Address - Fax:425-963-2256
Is Sole Proprietor?:Yes
Enumeration Date:2020-11-02
Last Update Date:2020-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA754716376G00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376G00000XNursing Service Related ProvidersNursing Home Administrator