| Wildwood Family Medicine, Llc | |
|
7319 N John Ave #101 Portland OR 97203-4885 | |
| (503) 289-3370 | |
| Not Available |
| Full Name | Wildwood Family Medicine, Llc |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 7319 N John Ave, Portland, Oregon |
| Authorized Official Name and Position | Lisa Bryant (OWNER) |
| Authorized Official Contact | 3609034866 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wildwood Family Medicine, Llc 315 W 24th St Vancouver WA 98660-2528 Ph: (360) 903-4866 | Wildwood Family Medicine, Llc 7319 N John Ave #101 Portland OR 97203-4885 Ph: (503) 289-3370 |
| NPI Number | 1952718579 |
|---|---|
| Provider Enumeration Date | 07/15/2014 |
| Last Update Date | 07/15/2014 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1952718579 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 1974 (Oregon) | Primary |
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