Provider Demographics
NPI:1316133796
Name:WOODS, ANN S
Entity type:Individual
Prefix:DR
First Name:ANN
Middle Name:S
Last Name:WOODS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17252 SW 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:KING CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97224-2224
Mailing Address - Country:US
Mailing Address - Phone:503-312-6464
Mailing Address - Fax:
Practice Address - Street 1:1940 TURNER RD SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97302-2003
Practice Address - Country:US
Practice Address - Phone:503-391-0756
Practice Address - Fax:503-391-0758
Is Sole Proprietor?:No
Enumeration Date:2007-09-19
Last Update Date:2020-01-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR3272ATI152W00000X, 152W00000X
CO3169152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist