Individual
DR. MERRILL WAGNER WEYERHAUSER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PHD
Contact information
Practice address
2106 NE 40TH AVENUE, PORTLAND, OR 97212
(503) 460-2530
(503) 282-0337
Mailing address
2106 NE 40TH AVENUE, PORTLAND, OR 97212
(503) 460-2530
(503) 282-0337
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
1448
OR
Other
Enumeration date
09/11/2008
Last updated
09/11/2008
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