Provider Demographics
NPI:1306291802
Name:WOODS, CHRISTOPHER M (PA-C)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:M
Last Name:WOODS
Suffix:
Gender:M
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2973 12TH STREET SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97302-3162
Mailing Address - Country:US
Mailing Address - Phone:503-561-7100
Mailing Address - Fax:503-561-7124
Practice Address - Street 1:2973 12TH STREET SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-3162
Practice Address - Country:US
Practice Address - Phone:503-561-7100
Practice Address - Fax:503-561-7124
Is Sole Proprietor?:No
Enumeration Date:2016-05-03
Last Update Date:2019-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORPA181919363AM0700X, 208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR500731282Medicaid
WA2085135Medicaid