Individual
BAX WILDER WHITE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSW
Contact information
Practice address
3615 NE GRAND AVE, PORTLAND, OR 97212-2104
(503) 281-1166
Mailing address
8982 N EXETER AVE, PORTLAND, OR 97203-5920
(503) 860-3064
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
OR
Other
Enumeration date
06/14/2022
Last updated
06/14/2022
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