Organization
WILDWOOD PSYCHIATRIC RESOURCE CENTER
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANN J. HOWARD MD (PRESIDENT)
(503) 690-8606
Entity
Organization
Contact information
Practice address
16110 SW REGATTA LN, BEAVERTON, OR 97006-8942
(503) 629-2131
(503) 617-9379
Mailing address
PO BOX 610, FAIRVIEW, OR 97024-0610
(503) 963-1221
(503) 230-1541
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
054123000
BLUE CROSS NUMBER
OR
Enumeration date
05/16/2006
Last updated
07/23/2009
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