Individual
SUSAN B WIGGINS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.ED, M.S
Contact information
Practice address
9750 NE GLISAN ST, PORTLAND, OR 97220-4449
(503) 256-3920
Mailing address
25117 SW PARKWAY AVE STE D, WILSONVILLE, OR 97070-9697
(971) 364-0611
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
17246
OR
Other
Enumeration date
10/27/2021
Last updated
10/27/2021
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