Individual
SAMUEL JAMES WILMARTH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7555 SW HERMOSO WAY STE 120, TIGARD, OR 97223-8684
(503) 345-3260
Mailing address
7555 SW HERMOSO WAY STE 120, TIGARD, OR 97223-8684
(503) 345-3260
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
C8858
OR
390200000X
Student in an Organized Health Care Education/Training Program
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Other
Enumeration date
05/27/2021
Last updated
09/24/2024
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