Individual
CHANDRA K WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
1438 SE DIVISION ST, PORTLAND, OR 97202-1140
(503) 548-0346
(503) 232-5959
Mailing address
1776 SW MADISON ST, PORTLAND, OR 97205-1715
(503) 224-1044
(503) 621-2235
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
—
OR
Other
Enumeration date
01/23/2020
Last updated
02/12/2020
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