Individual
MARK WILKISON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
9155 SW BARNES RD STE 420, PORTLAND, OR 97225-6631
(503) 297-6334
Mailing address
3181 SW SAM JACKSON PARK ROAD, L579 OHSU,, PORTLAND, OR 97239-3098
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
MD184323
OR
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/16/2015
Last updated
05/10/2018
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