Active NPI
J. Walter Wood, PHD
- Clinical Psychologist
- Eugene, OR
National Provider Identifier
1508874025
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 1288
- Practice address
- 901 E 18TH Ave
Eugene, OR 97403-1354 - Phone
- (541) 346-3575
- NPI assigned
- Aug 3, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 1288 | OR | Primary |
Addresses
Primary practice location
901 E 18TH Ave
Eugene, OR 97403-1354
Mailing address
2156 Silhouette St.
Eugene, OR 97402
Phone (541) 505-8758
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 295841 | Medicaid | OR |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1288 | OR | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1233619200000",
"number": "1508874025",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2156 SILHOUETTE ST.",
"city": "EUGENE",
"state": "OR",
"postal_code": "97402",
"telephone_number": "541-505-8758"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "901 E 18TH AVE",
"city": "EUGENE",
"state": "OR",
"postal_code": "974031354",
"telephone_number": "541-346-3575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WOOD",
"first_name": "J.",
"middle_name": "WALTER",
"credential": "PHD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2009-02-03",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "OR",
"license": "1288",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "295841",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Eugene, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.