Individual
ERICA P WOODY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHP-R
Contact information
Practice address
12360 E BURNSIDE ST, PORTLAND, OR 97233-1042
(971) 279-4800
(971) 279-2051
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
20-QMHP-R-0246
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
500782234
—
OR
Enumeration date
07/21/2020
Last updated
03/16/2021
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