Individual
KENNETH WOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
CRM
Contact information
Practice address
1376 FRUITVALE RD # DAY, NEWPORT, OR 97365-9671
(541) 265-7945
Mailing address
1376 FRUITVALE RD, NEWPORT, OR 97365-9671
(541) 270-8767
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
OR
Other
Enumeration date
09/28/2019
Last updated
01/15/2020
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