Individual
IAN WILKINSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LAC
Contact information
Practice address
4829 NE MARTIN LUTHER KING JR BLVD, PORTLAND, OR 97211-3491
(541) 706-1888
Mailing address
64718 STARWOOD DR, BEND, OR 97703-8426
(541) 706-1888
Taxonomy
Speciality
Code
Description
License number
State
171100000X
Acupuncturist
Primary
AC179984
OR
Other
Enumeration date
11/22/2016
Last updated
11/22/2016
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