Provider Demographics
NPI:1467294959
Name:WOODLAND, JOSEPH ALLEN
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:ALLEN
Last Name:WOODLAND
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1722 E SPRAGUE AVE STE 214
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99202-3109
Mailing Address - Country:US
Mailing Address - Phone:509-505-9614
Mailing Address - Fax:
Practice Address - Street 1:1722 E SPRAGUE AVE STE 214
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99202-3109
Practice Address - Country:US
Practice Address - Phone:509-505-9614
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-07
Last Update Date:2024-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA61539487106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician