Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207X00000X | Orthopaedic Surgeon | OA60630396 | WA |
N | 207XS0117X | Orthopaedic Spine Surgeon | OA60630396 | WA |
NPI | 1023314820 |
---|---|
Provider Name | Matthew Corey Woolf |
First Address | Kennewick, WA 99336-2623 |
Second Address | Kennewick, WA 99336-2623 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2011 |
Last Update Date | 02/08/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
2045068 | (05) | WA |