Individual
BRIAN WETZEL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
N.P
Contact information
Practice address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7008
(503) 494-4997
Mailing address
3181 SW SAM JACKSON PARK RD, PORTLAND, OR 97239-3011
(503) 494-7008
(503) 494-4997
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
200841106RN
OR
363LA2100X
Acute Care Nurse Practitioner
Primary
200850057NP
OR
Other
Enumeration date
10/27/2006
Last updated
04/22/2010
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