Individual
AIDAN THOMAS WANDSCHNEIDER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
606 MEDICAL PKWY, ENTERPRISE, OR 97828-5140
(541) 426-4524
Mailing address
606 MEDICAL PKWY, ENTERPRISE, OR 97828-5140
(541) 426-4524
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
—
—
175T00000X
Peer Specialist
Primary
THW000108967
OR
Other
Enumeration date
01/20/2023
Last updated
05/24/2023
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