Provider Demographics
NPI:1851485338
Name:WOODSIDE & WOODSIDE
Entity Type:Organization
Organization Name:WOODSIDE & WOODSIDE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:COLLINS
Authorized Official - Middle Name:
Authorized Official - Last Name:WOODSIDE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:206-323-6555
Mailing Address - Street 1:1901 42ND AVE. E.
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1901 42ND AVE. E.
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112
Practice Address - Country:US
Practice Address - Phone:206-323-6555
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA000082021223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty