Individual
MR. BRET ANTHONY WONDERLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.S. CCC-A
Contact information
Practice address
1849 NW KEARNEY ST, SUITE 200, PORTLAND, OR 97209-1453
(971) 570-5387
Mailing address
2702 NE BRYCE ST, PORTLAND, OR 97212-1638
(503) 567-9392
Taxonomy
Speciality
Code
Description
License number
State
231H00000X
Audiologist
Primary
21957
OR
Other
Enumeration date
12/17/2012
Last updated
06/12/2013
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