Individual
CORY ROBERT WOODYATT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
AGACNP-BC, RN
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7551
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7551
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
10024035
OR
363LA2100X
Acute Care Nurse Practitioner
201900770RN
OR
Other
Enumeration date
11/17/2022
Last updated
03/05/2025
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