Individual
EARL DEAN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
8305 SE MONTEREY AVE, 220, HAPPY VALLEY, OR 97086-7725
(503) 659-4082
(503) 659-4951
Mailing address
8305 SE MONTEREY AVE, HAPPY VALLEY, OR 97086-7725
(503) 659-4082
(503) 659-4951
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
375
OR
Other
Enumeration date
06/20/2010
Last updated
06/20/2010
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