Provider Demographics
NPI:1003092321
Name:WOODFIN, ROSE MARIE (BS)
Entity Type:Individual
Prefix:MISS
First Name:ROSE
Middle Name:MARIE
Last Name:WOODFIN
Suffix:
Gender:F
Credentials:BS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1790 W 11TH AVE
Mailing Address - Street 2:SUITE 290
Mailing Address - City:EUGENE
Mailing Address - State:OR
Mailing Address - Zip Code:97402-3758
Mailing Address - Country:US
Mailing Address - Phone:541-686-1262
Mailing Address - Fax:
Practice Address - Street 1:780 HWY 99 N
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97402-2301
Practice Address - Country:US
Practice Address - Phone:541-461-2845
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2008-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health