# WILDWOOD HEALTH AND WELLNESS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1013513472
- **Authorized official:** ALLISON RENEE ROTT PA-C (PHYSICIAN ASSISTANT)
- **Authorized official phone:** (303) 929-8993

## Contact information

- **Practice address:** 16100 NW CORNELL RD STE 220, BEAVERTON, OR 97006-7334
- **Practice address phone:** (303) 929-8993
- **Mailing address:** 4906 NE CLEVELAND AVE, PORTLAND, OR 97211-2718
- **Mailing address phone:** (303) 929-8993

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |
| 2084N0400X | Neurology Physician | — | NULL | — |
| 2084N0400X | Neurology Physician | — | — | — |

## Other

- **Enumeration date:** 12/09/2020
- **Last updated:** 12/23/2020