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Individual

RUTH E WILCOX

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
10000 SE MAIN ST, SUITE 116, PORTLAND, OR 97216-2448
(503) 251-6292
Mailing address
PO BOX 92900, PORTLAND, OR 97292-0900

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
A33367
CA
207Q00000X
Family Medicine Physician
Primary
MD11970
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
222091
OR
Enumeration date
04/11/2006
Last updated
03/17/2010
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