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1740906916
WILDER HEARTWOOD
PORTLAND, OR
NPI
1740906916
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
101YA0400X Counselor, Addiction (Substance Use Disorder)
Enumeration Date
2022-10-18
Last Update Date
2022-10-18
Business Address
WILDER HEARTWOOD CADC-R
2720 NE FLANDERS ST
PORTLAND, OR 97232-3160
Phone number: 503-238-5203
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Mailing Address
WILDER HEARTWOOD CADC-R
2405 SE 105TH AVE
PORTLAND, OR 97216-3050
Phone number:
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