Provider Demographics
NPI:1629361548
Name:WOOD-BOEN, WENDY (RN)
Entity Type:Individual
Prefix:
First Name:WENDY
Middle Name:
Last Name:WOOD-BOEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5223 16TH CT NE
Mailing Address - Street 2:
Mailing Address - City:KEIZER
Mailing Address - State:OR
Mailing Address - Zip Code:97303-3607
Mailing Address - Country:US
Mailing Address - Phone:503-887-2222
Mailing Address - Fax:
Practice Address - Street 1:5223 16TH CT NE
Practice Address - Street 2:
Practice Address - City:KEIZER
Practice Address - State:OR
Practice Address - Zip Code:97303-3607
Practice Address - Country:US
Practice Address - Phone:503-887-2222
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-25
Last Update Date:2011-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR200442422RN163WC0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0200XNursing Service ProvidersRegistered NurseCritical Care Medicine