Individual
JOHANNA CLAIRE WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
222 SE 8TH AVE # HPC2, HILLSBORO, OR 97123-4218
(503) 352-7217
Mailing address
2514 FALLS ST, FOREST GROVE, OR 97116-2993
(541) 370-5114
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
02/27/2020
Last updated
02/27/2020
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