Individual
JOANNA LOUISE WILDER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN-NP, CNM, CPM
Contact information
Practice address
12665 SW HALL BLVD, TIGARD, OR 97223-6217
(503) 896-0170
(971) 264-5335
Mailing address
12665 SW HALL BLVD, TIGARD, OR 97223-6217
(503) 896-0170
(971) 264-5335
Taxonomy
Speciality
Code
Description
License number
State
367A00000X
Advanced Practice Midwife
Primary
10001034
OR
Other
Enumeration date
08/20/2010
Last updated
11/18/2023
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