Individual
CHARLES TODD WOOLLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2222 NW LOVEJOY, SUITE 401, PORTLAND, OR 97210
(503) 274-4865
(503) 274-4989
Mailing address
2222 NW LOVEJOY, SUITE 401, PORTLAND, OR 97210
(503) 274-4865
(503) 274-4989
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD23565
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286747
—
OR
Enumeration date
01/09/2006
Last updated
09/10/2009
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