Individual
MICHAEL A WILSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9427 SW BARNES RD, STE 498, PORTLAND, OR 97225-6652
(503) 216-0900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD15370
OR
207RI0011X
Interventional Cardiology Physician
MD00049331
WA
207RI0011X
Interventional Cardiology Physician
Primary
MD15370
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
202895
—
OR
01
—
P00848627
RR MEDICARE
OR
01
—
P00909394
RR MEDICARE
WA
Enumeration date
06/20/2006
Last updated
03/25/2021
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us