TED WOODRUFF CRM NPI 1003325200

NPI Information

NPI: 1003325200
Provider Name: TED WOODRUFF, CRM
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
3425 13TH ST
BAKER CITY, OR
ZIP 97814
Phone: (541) 523-7400
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Ted Woodruff, CRM is an addiction (substance use disorder) counselor in Baker City, OR. Ted Woodruff, CRM NPI is 1003325200. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

3425 13TH ST
BAKER CITY, OR
ZIP 97814-340
Phone: (541) 523-7400
Fax: (541) 523-4927

The enumeration date for this NPI number is 9/20/2017 and was last updated on 7/6/2021.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	T-20-391	OREGON	Yes
2	101YA0400X	Counselor	Addiction (Substance Use Disorder)	14-CRM-024	OREGON	No
3	175T00000X	Peer Specialist		THW000000864	OREGON	No

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	14-CRM-024	OTHER	OREGON	MHACBO CRM
2	500609571	MEDICAID	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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