Individual
MR. THEODORE JAY WOLFINGTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4822 NE 12TH AVE, PORTLAND, OR 97211-4620
(503) 287-0606
Mailing address
4822 NE 12TH AVE, PORTLAND, OR 97211-4620
(503) 287-0606
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
372600000X
Adult Companion
Primary
—
—
Other
Enumeration date
02/01/2007
Last updated
09/11/2025
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