IRVIN D WILSON

PORTLAND, OR
NPI1952931776
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  20-11-14)
Enumeration Date2020-01-21
Last Update Date2022-06-29
Business Address
IRVIN D WILSON CADC I
17645 NW SAINT HELENS RD
PORTLAND, OR 97231-1729
Phone number: 503-621-1069
Mailing Address
IRVIN D WILSON CADC I
1776 SW MADISON ST
PORTLAND, OR 97205-1715
Phone number: 503-224-1044
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