Individual
MR. JEFFREY ROBERT WOOTEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
412 SW 12TH AVE, PORTLAND, OR 97205-2329
(503) 228-7134
Mailing address
6620 NE 6TH AVE, APT 8, PORTLAND, OR 97211-3065
(503) 978-1738
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
01/25/2007
Last updated
07/08/2007
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