Individual
MAEGAN WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
7003 SE WOODSTOCK BLVD, PORTLAND, OR 97206-5940
(503) 771-2271
Mailing address
3117 SE ANKENY ST APT 1, PORTLAND, OR 97214-1901
Taxonomy
Speciality
Code
Description
License number
State
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
03/21/2007
Last updated
07/08/2007
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