Individual
WENDY NOELLE WAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PMHNP
Contact information
Practice address
1520 PLAZA ST NW, SALEM, OR 97304-4658
(503) 585-3012
Mailing address
1855 SAGINAW ST S, SALEM, OR 97302-5233
(503) 551-0386
(503) 585-0128
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
201393325NP-PP
OR
Other
Enumeration date
10/28/2013
Last updated
02/15/2016
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