Individual
CORRINE WILSON-BAURICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPC
Contact information
Practice address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 645-3581
Mailing address
14600 NW CORNELL RD, PORTLAND, OR 97229-5442
(503) 645-3581
Taxonomy
Speciality
Code
Description
License number
State
101YP2500X
Professional Counselor
Primary
3706
OR
101YP2500X
Professional Counselor
546
AK
Other
Enumeration date
08/07/2007
Last updated
01/05/2016
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