Provider Demographics
NPI:1164625174
Name:HOOD, LAYNE E (MSW)
Entity Type:Individual
Prefix:MR
First Name:LAYNE
Middle Name:E
Last Name:HOOD
Suffix:
Gender:M
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1012 NW WALL ST
Mailing Address - Street 2:STE 210
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-2048
Mailing Address - Country:US
Mailing Address - Phone:541-390-5373
Mailing Address - Fax:480-247-5521
Practice Address - Street 1:1012 NW WALL ST
Practice Address - Street 2:STE 210
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-2048
Practice Address - Country:US
Practice Address - Phone:541-390-5373
Practice Address - Fax:480-247-5521
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR18881041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
0000THLGLMedicare ID - Type Unspecified