Individual
TRISHA DAWN WONDERLICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
OTR/L
Contact information
Practice address
3060 SE STARK STREET, PORTLAN, OR 97214
(503) 535-4700
Mailing address
25117 SOUTHWEST PARKWAY, SUITE D, WILLSONVILLE, OR 97070
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
991966
OR
Other
Enumeration date
09/30/2013
Last updated
09/30/2013
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