Individual
MICHAEL R DEWILDE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
4115 NE 165TH PL, VANCOUVER, WA 98682-8743
(503) 881-1059
Mailing address
4115 NE 165TH PL, VANCOUVER, WA 98682-8743
Taxonomy
Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
—
—
Other
Enumeration date
03/13/2024
Last updated
03/13/2024
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