STACEY L WILSON

BEAVERTON, OR
NPI1629102272
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LX0001X Nurse Practitioner, Obstetrics & Gynecology
(Licence: OR  OR 200050017NP)
Enumeration Date2007-03-15
Last Update Date2008-04-29
Business Address
-- STACEY L WILSON CNM
4855 SW WESTERN AVE
BEAVERTON, OR 97005-3460
Phone number: 503-626-5515
Mailing Address
-- STACEY L WILSON CNM
8646 NW SKYLINE BLVD
PORTLAND, OR 97231-2618
Phone number:
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