Theodore Roy Woodruff, CRM

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

T-20-391 Issued in OR

Practice address

400 Virginia Ave
North Bend, OR 97459-3477

Phone

(541) 751-0357

NPI assigned

Sep 20, 2017

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• New Directions Northwest, Inc

  • Community/Behavioral Health Agency
  • Baker City, OR
  • NPI 1235124462
  NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1505865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1772582400000",
    "number": "1003325200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1121",
            "city": "ROSEBURG",
            "state": "OR",
            "postal_code": "974700254",
            "telephone_number": "541-672-2691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 VIRGINIA AVE",
            "city": "NORTH BEND",
            "state": "OR",
            "postal_code": "974593477",
            "telephone_number": "541-751-0357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WOODRUFF",
        "first_name": "THEODORE",
        "middle_name": "ROY",
        "credential": "CRM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-09-20",
        "last_updated": "2026-03-04",
        "certification_date": "2026-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OR",
            "license": "T-20-391",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "500609571",
            "state": "OR"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MHACBO CRM",
            "identifier": "14-CRM-024",
            "state": "OR"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sherry Lynn Windham
• Chelsea Wolgast
• Stefanie Robin Wolverton
• Benjamin Brian Wood
• Paul Woodhead
• Morgan Woods
• Iredell Camuel Wyatt IV
• Kimberly Rene Wyatt, LMT
• Benjamin Yester I
• Rebekah Young

• Addiction (Substance Use Disorder) Counselor in North Bend, OR
• Providers in North Bend, OR by specialty
• Addiction (Substance Use Disorder) Counselor in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.