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NPI Code Detail

MEDICARE: MR. ALLAN W. WOOD LCSW

MEDICARE: MR. ALLAN W. WOOD LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social WorkerL2346OR

General Provider Information

NPI Number : 1841370350
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. ALLAN W. WOOD LCSW
Provider Business Mailing Address
First Line : 1905 SE PINE ST
Second Line :
City : PORTLAND
State : OR
Zip : 97214-1544
Country : US
Telephone Number : 503-236-5237
Fax Number : 503-646-8401
Provider Business Practice Location Address
First Line : 9670 SW BEAVERTON HILLSDALE HWY
Second Line :
City : BEAVERTON
State : OR
Zip : 97005-3307
Country : US
Telephone Number : 503-626-9494
Fax Number : 503-646-8401
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/17/2006
Last Update Date : 07/08/2007

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