Provider Demographics
NPI:1861493884
Name:WOODSUM-REED, SUZANNE ELLEN (MSW)
Entity Type:Individual
Prefix:
First Name:SUZANNE
Middle Name:ELLEN
Last Name:WOODSUM-REED
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:SUZANNE
Other - Middle Name:ELLEN
Other - Last Name:LUBKER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:525 LILLY RD NE
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98506-5101
Mailing Address - Country:US
Mailing Address - Phone:360-493-7230
Mailing Address - Fax:360-493-4180
Practice Address - Street 1:525 LILLY RD NE
Practice Address - Street 2:
Practice Address - City:OLYMPIA
Practice Address - State:WA
Practice Address - Zip Code:98506-5101
Practice Address - Country:US
Practice Address - Phone:360-493-7230
Practice Address - Fax:360-493-4180
Is Sole Proprietor?:No
Enumeration Date:2005-08-02
Last Update Date:2007-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW00006650104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker