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Individual

TODD WYMER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
LAC

Contact information

Practice address
1330 SE CESAR E CHAVEZ BLVD, PORTLAND, OR 97214-4322
(503) 232-1100
Mailing address
130 SE 105TH AVE APT B1, PORTLAND, OR 97216-2955
(541) 787-9301

Taxonomy

Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC165723
OR

Other

Enumeration date
07/28/2014
Last updated
07/28/2014
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