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MR. ADAM CHRISTIAN WACHTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PT

Contact information

Practice address
17449 BOONES FERRY RD, STE. 300, LAKE OSWEGO, OR 97035-6206
(503) 635-0844
(503) 638-0812
Mailing address
16083 SW UPPER BOONES FERRY RD, SUITE 300, TIGARD, OR 97224-7736
(800) 219-8835
(503) 639-9699

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
29521
CA
225100000X
Physical Therapist
Primary
OR 6654
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
500643799
OR
01
ZZZ66237Z
BLUE SHIELD
CA
Enumeration date
08/08/2006
Last updated
11/13/2012
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