Individual
JENNIFER WILKESON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3500 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97212-2093
(503) 765-7355
Mailing address
57502 ALDER CREEK RD, SCAPPOOSE, OR 97056-2121
(503) 543-4035
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6814
OR
Other
Enumeration date
03/18/2015
Last updated
03/18/2015
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