Individual
MR. WYATT JAMES BROWN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
C.PED.
Contact information
Practice address
16679 BOONES FERRY RD, STE 215, LAKE OSWEGO, OR 97035-4365
(503) 699-1911
(503) 699-1912
Mailing address
16679 BOONES FERRY RD STE 215, LAKE OSWEGO, OR 97035-4368
(503) 699-1911
(503) 699-1912
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
0876099-5
OR
Other
Enumeration date
02/08/2007
Last updated
04/03/2012
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