Individual
JAIME WILDMAN PETERSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239
(503) 418-5700
(503) 418-5704
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 418-5700
(503) 418-5704
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD190221
OR
Other
Enumeration date
04/09/2012
Last updated
11/30/2018
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