Provider Demographics
NPI:1851709380
Name:WOOD, GENIE (RPH)
Entity Type:Individual
Prefix:
First Name:GENIE
Middle Name:
Last Name:WOOD
Suffix:
Gender:F
Credentials:RPH
Other - Prefix:
Other - First Name:GENIE
Other - Middle Name:
Other - Last Name:CROUCH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2700 WASCO ST
Mailing Address - Street 2:
Mailing Address - City:HOOD RIVER
Mailing Address - State:OR
Mailing Address - Zip Code:97031-1049
Mailing Address - Country:US
Mailing Address - Phone:541-387-2333
Mailing Address - Fax:541-387-2332
Practice Address - Street 1:2700 WASCO ST
Practice Address - Street 2:
Practice Address - City:HOOD RIVER
Practice Address - State:OR
Practice Address - Zip Code:97031-1049
Practice Address - Country:US
Practice Address - Phone:541-387-2333
Practice Address - Fax:541-387-2332
Is Sole Proprietor?:No
Enumeration Date:2014-07-28
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR9267183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist