Individual
DR. DAVID SCOTT WAKELING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
19300 SW 65TH AVE, TUALATIN, OR 97062-7706
(503) 692-2430
Mailing address
3912 SW ALTADENA AVE, PORTLAND, OR 97239
(503) 753-5493
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
DO15848
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
048160
—
OR
Enumeration date
03/29/2006
Last updated
03/23/2011
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