Provider Demographics
NPI:1104440510
Name:WOODS, TAMARA LEANNE (MSW, QMHP)
Entity type:Individual
Prefix:MS
First Name:TAMARA
Middle Name:LEANNE
Last Name:WOODS
Suffix:
Gender:F
Credentials:MSW, QMHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:525 E 19TH AVE APT 8
Mailing Address - Street 2:
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97401-9114
Mailing Address - Country:US
Mailing Address - Phone:602-703-2613
Mailing Address - Fax:
Practice Address - Street 1:2655 MARTIN LUTHER KING JR BLVD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97401-5899
Practice Address - Country:US
Practice Address - Phone:541-650-6557
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2020-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health