Individual
WILSON LEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
435 LIBERTY ST NE, SALEM, OR 97301-3588
(503) 362-3654
Mailing address
435 LIBERTY ST NE, SALEM, OR 97301-3588
(503) 362-3654
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
0018766
OR
Other
Enumeration date
11/03/2020
Last updated
01/10/2022
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