Individual
MRS. ANNE MARIE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
3664 FAIRHAVEN DR, WEST LINN, OR 97068-3779
(503) 409-0838
Mailing address
3664 FAIRHAVEN DR, WEST LINN, OR 97068-3779
(503) 409-0838
Taxonomy
Speciality
Code
Description
License number
State
163WC1500X
Community Health Registered Nurse
Primary
097000152RN
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
097000152RN
RN NUMBER
OR
Enumeration date
07/23/2020
Last updated
07/23/2020
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