Individual
ANN ELAINE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.C.
Contact information
Practice address
4410 NE FREMONT ST, PORTLAND, OR 97213-1154
(503) 249-0114
(503) 249-5638
Mailing address
4410 NE FREMONT ST, PORTLAND, OR 97213-1154
(503) 249-0114
(503) 249-5638
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
27 2903
OR
Other
Enumeration date
06/21/2007
Last updated
07/08/2007
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