Individual
DR. JOHN CAMPBELL WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
3550 N INTERSTATE AVE, EAST INTERSTATE MEDICAL OFFICE - MENTAL HEALTH, PORTLAND, OR 97227-1196
(503) 249-3434
Mailing address
3550 N INTERSTATE AVE, EAST INTERSTATE MEDICAL OFFICE - MENTAL HEALTH, PORTLAND, OR 97227-1196
(503) 249-3434
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD158028
OR
2084P0805X
Geriatric Psychiatry Physician
MD158028
OR
Other
Enumeration date
04/07/2010
Last updated
02/01/2022
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