Individual
JEFF ALLAN WIESINGER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CHW
Contact information
Practice address
2870 BROADWAY ST NE, SALEM, OR 97303-6500
(971) 387-6918
(971) 374-2551
Mailing address
441 24TH ST NE, SALEM, OR 97301-4450
(907) 317-5923
(971) 374-2551
Taxonomy
Speciality
Code
Description
License number
State
172V00000X
Community Health Worker
Primary
THW000108072
OR
Other
Enumeration date
01/04/2023
Last updated
01/04/2023
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