Healthcare Provider Details

I. General information

NPI: 1861338063
Provider Name (Legal Business Name): JOSEPH ALEXANDER WOERNER CRM, PWS, PSS
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: VILLANELLE ALEXANDRA WOERNER CRM, PWS, PSS

II. Dates (important events)

Enumeration Date: 04/28/2026
Last Update Date: 04/28/2026
Certification Date: 04/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10700 SW BEAVERTON HILLSDALE HWY STE 11
BEAVERTON OR
97005-3035
US

IV. Provider business mailing address

8121 SE RAMONA ST
PORTLAND OR
97206-5154
US

V. Phone/Fax

Practice location:
  • Phone: 971-294-0770
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175T00000X
TaxonomyPeer Specialist
License Number116928
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: