Individual
MS. SUSAN MARIE WILMOTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
L. AC.
Contact information
Practice address
5525 E BURNSIDE ST, PORTLAND, OR 97215-1258
(503) 333-3722
(503) 233-4449
Mailing address
5525 E BURNSIDE ST, PORTLAND, OR 97215-1258
(503) 333-3722
(503) 233-4449
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC01133
OR
Other
Enumeration date
11/26/2007
Last updated
11/26/2007
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