Individual
DR. ALEC WILSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PSYD
Contact information
Practice address
3050 SE DIVISION ST # 260, PORTLAND, OR 97202-1451
(503) 757-6259
Mailing address
3050 SE DIVISION ST # 260, PORTLAND, OR 97202-1451
(503) 757-6259
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
2354
OR
Other
Enumeration date
03/11/2014
Last updated
03/11/2014
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