Organization
JMW PSYCHIATRY MD LLC
Active
Organization
JMW PSYCHIATRY MD LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JONATHAN WILSON MD (MANAGER)
(503) 213-6167
Entity
Organization
Contact information
Practice address
311 B AVE STE R, LAKE OSWEGO, OR 97034-3071
(503) 213-6167
Mailing address
311 B AVE STE R, LAKE OSWEGO, OR 97034-3071
(503) 213-6167
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
—
—
Other
Enumeration date
04/20/2021
Last updated
09/29/2021
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