Provider Demographics
NPI:1447342027
Name:HOOD, CONSTANCE P (PAC)
Entity type:Individual
Prefix:
First Name:CONSTANCE
Middle Name:P
Last Name:HOOD
Suffix:
Gender:F
Credentials:PAC
Other - Prefix:
Other - First Name:CONNIE
Other - Middle Name:
Other - Last Name:HOOD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:24080 SE KENT KANGLEY RD
Mailing Address - Street 2:
Mailing Address - City:MAPLE VALLEY
Mailing Address - State:WA
Mailing Address - Zip Code:98038-6801
Mailing Address - Country:US
Mailing Address - Phone:253-372-7680
Mailing Address - Fax:
Practice Address - Street 1:24080 SE KENT KANGLEY RD
Practice Address - Street 2:
Practice Address - City:MAPLE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:98038-6801
Practice Address - Country:US
Practice Address - Phone:253-372-7680
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-09-29
Last Update Date:2012-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPA10002229363A00000X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical