Individual
BETHANIE WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRM
Contact information
Practice address
1217 NE BURNSIDE RD STE 701, GRESHAM, OR 97030-5770
(503) 740-1971
Mailing address
1217 NE BURNSIDE RD STE 701, GRESHAM, OR 97030-5770
(503) 740-1971
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary
25-CRM-4634
OR
Other
Enumeration date
07/22/2025
Last updated
07/22/2025
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