Individual
ANDREW WIENCKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
17070 SE MCLOUGHLIN BLVD, MILWAUKIE, OR 97267-4960
(503) 594-1773
Mailing address
14600 NW CORNELL RD, PORTL, IS THE CEDAR MILL ADDRESS -, PORTLAND, OR 97229
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
—
—
Other
Enumeration date
06/19/2014
Last updated
06/19/2014
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