Individual
MRS. MARY TERESA WIKANDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW
Contact information
Practice address
120 SO ELLIOTT RD, STE 200, NEWBERG, OR 97132
(503) 539-2843
Mailing address
PO BOX 212, BEAVERTON, OR 97005
(503) 539-2843
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
L3702
OR
Other
Enumeration date
05/08/2007
Last updated
07/08/2007
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