Individual
ELAINE WYNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2043 COLLEGE WAY, FOREST GROVE, OR 97116-1756
(503) 352-2202
Mailing address
1625 21ST AVE, FOREST GROVE, OR 97116-1601
(541) 609-0449
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/31/2016
Last updated
03/31/2016
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