Organization
WILDWOOD HEALTH AND WELLNESS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ALLISON RENEE ROTT PA-C (PHYSICIAN ASSISTANT)
(303) 929-8993
Entity
Organization
Contact information
Practice address
16100 NW CORNELL RD STE 220, BEAVERTON, OR 97006-7334
(303) 929-8993
Mailing address
4906 NE CLEVELAND AVE, PORTLAND, OR 97211-2718
(303) 929-8993
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
2084N0400X
Neurology Physician
—
—
Other
Enumeration date
12/09/2020
Last updated
12/23/2020
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