Individual
SHILO VICTORIA WITTROCK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 645-3581
Mailing address
508 PEGASUS CT, MOLALLA, OR 97038-9213
(503) 750-3363
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
Primary
—
—
Other
Enumeration date
07/11/2012
Last updated
07/11/2012
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