Individual
DR. ROGER A WICKLUND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9135 SW BARNES RD, STE. 663, PORTLAND, OR 97225-6646
(503) 297-1078
(503) 292-2176
Mailing address
9135 SW BARNES RD, STE. 663, PORTLAND, OR 97225-6646
(503) 297-1078
(503) 292-2176
Taxonomy
Speciality
Code
Description
License number
State
208800000X
Urology Physician
MD00034648
WA
208800000X
Urology Physician
Primary
MD09630
OR
Other
Enumeration date
08/27/2006
Last updated
10/16/2012
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