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Individual

ANNMARIE WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
17214 SE DIVISION ST, SUITE 2, PORTLAND, OR 97236-1282
(503) 761-5272
(503) 762-6250
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary

Other

Enumeration date
05/09/2012
Last updated
05/09/2012
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