Individual
NATHALIE WUEBKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
722 NE 162ND AVE, PORTLAND, OR 97230-5760
(503) 239-8101
Mailing address
424 NE 22ND AVE, PORTLAND, OR 97232-2809
Taxonomy
Speciality
Code
Description
License number
State
374700000X
Technician
Primary
—
—
Other
Enumeration date
05/18/2020
Last updated
05/18/2020
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