Organization
WILDWOOD FAMILY MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. LISA BRYANT N.D. (OWNER)
(360) 903-4866
Entity
Organization
Contact information
Practice address
7319 N JOHN AVE, #101, PORTLAND, OR 97203-4885
(503) 289-3370
Mailing address
315 W 24TH ST, VANCOUVER, WA 98660-2528
(360) 903-4866
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
1974
OR
Other
Enumeration date
07/15/2014
Last updated
07/15/2014
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