Individual
MRS. ANDREA MARIE WILKIE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
10102 NE GLISAN ST, PORTLAND, OR 97220-4456
(503) 257-5959
Mailing address
4936 SE 108TH AVE, PORTLAND, OR 97266-3408
(503) 519-2603
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H6314
OR
126800000X
Dental Assistant
—
—
Other
Enumeration date
04/16/2007
Last updated
09/20/2012
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