Individual
DR. KRISTIN ILYSSA WING
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ND
Contact information
Practice address
4605 NE FREMONT ST STE 201C, PORTLAND, OR 97213-1715
(503) 406-8721
(971) 386-1082
Mailing address
4605 NE FREMONT ST STE 201C, PORTLAND, OR 97213-1715
(503) 406-8721
(971) 386-1082
Taxonomy
Speciality
Code
Description
License number
State
175F00000X
Naturopath
Primary
4124
OR
Other
Enumeration date
10/01/2017
Last updated
07/13/2022
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