Individual
WILDER HEARTWOOD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CADC-R
Contact information
Practice address
2720 NE FLANDERS ST, PORTLAND, OR 97232-3160
(503) 238-5203
Mailing address
2405 SE 105TH AVE, PORTLAND, OR 97216-3050
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
10/18/2022
Last updated
10/18/2022
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