Individual
ALF EDWARD WYLLER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
10100 SW SUNNYSIDE RD., CLACKAMAS, OR 97015
(503) 786-8435
Mailing address
30203 SW LADD HILL RD., PO BOX 817, SHERWOOD, OR 97140
Taxonomy
Speciality
Code
Description
License number
State
302R00000X
Health Maintenance Organization
Primary
MD11882
OR
Other
Enumeration date
10/05/2006
Last updated
07/08/2007
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