Individual
TIMOTHY WOODRUM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2045 SILVERTON RD NE STE B, SALEM, OR 97301-0100
(503) 763-5739
Mailing address
888 FAIRVIEW AVE SE APT 33, SALEM, OR 97302-3183
(310) 903-2162
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
12/11/2017
Last updated
12/15/2020
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