Individual
MS. MARY PEARL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LMT
Contact information
Practice address
9600 SW OAK ST STE 410, PORTLAND, OR 97223-6581
(503) 308-8676
Mailing address
7728 SW 30TH AVE, PORTLAND, OR 97219-2411
(503) 676-0462
Taxonomy
Speciality
Code
Description
License number
State
172M00000X
Mechanotherapist
Primary
29521
OR
Other
Enumeration date
02/18/2026
Last updated
02/18/2026
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