Organization
WILDWOOD RECONNECTIONS LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM DAVID YAGER LAC (OWNER/PRESIDENT)
(503) 252-2949
Entity
Organization
Contact information
Practice address
305 NE 78THE AVE, PORTLAND, OR 97213
(503) 252-2949
Mailing address
305 NE 78THE AVE, PORTLAND, OR 97213
(503) 252-2949
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC01062
OR
Other
Enumeration date
02/11/2008
Last updated
11/13/2009
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