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Individual

DR. ADDISON R WILSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
15285 NW CENTRAL DR, PORTLAND, OR 97229-0973
(503) 216-9060
(503) 216-9098
Mailing address
PO BOX 13994, PORTLAND, OR 97213-0994
(503) 215-6494
(503) 215-6644

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD17686
OR

Other

Enumeration date
07/07/2006
Last updated
07/08/2007
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