Individual
LORRI B WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
3375 SW TERWILLIGER BLVD, PORTLAND, OR 97239-4146
(215) 292-2953
Mailing address
3375 SW TERWILLIGER BLVD, PORTLAND, OR 97239-4146
(503) 494-3000
(503) 494-4286
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
MD154363
OR
207WX0110X
Pediatric Ophthalmology and Strabismus Specialist Physician
Primary
MD154363
OR
Other
Enumeration date
12/28/2006
Last updated
11/02/2017
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