| Victoria Wisdom-imbach | |
|
528 Cottage St Ne Salem OR 97301-3811 | |
| (303) 946-9071 | |
| (267) 288-0775 |
| Full Name | Victoria Wisdom-imbach |
|---|---|
| Speciality | Counselor - Professional |
| Location | 528 Cottage St Ne, Salem, Oregon |
| Authorized Official Name and Position | Victoria Wisdom-imbach (OWNER) |
| Authorized Official Contact | 3039469071 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Victoria Wisdom-imbach 295 Church St Se Apt 305 Salem OR 97301-3832 Ph: (303) 946-9071 | Victoria Wisdom-imbach 528 Cottage St Ne Salem OR 97301-3811 Ph: (303) 946-9071 |
| NPI Number | 1295251437 |
|---|---|
| Provider Enumeration Date | 08/18/2017 |
| Last Update Date | 08/18/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1295251437 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YP2500X | Counselor - Professional | C3841 (Oregon) | Primary |
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