Individual
MEGAN JEAN WACKFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 652-2880
Mailing address
14679 SE CHRISTINA CT, CLACKAMAS, OR 97015-8460
(541) 543-7192
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
RT-P-10121226
OR
Other
Enumeration date
06/14/2010
Last updated
06/14/2010
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