Individual
ROGER WILDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
3871 FAIRVIEW INDUSTRIAL DR SE, ST #105, SALEM, OR 97302-1180
(503) 391-9765
(503) 391-2019
Mailing address
3871 FAIRVIEW INDUSTRIAL DR SE, ST #105, SALEM, OR 97302
(503) 391-9765
(503) 391-2019
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
13-09-59
OR
Other
Enumeration date
12/12/2014
Last updated
12/12/2014
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