NPI 1003978610
Maureen L Wiese, CPED
Practice location
- Address
- 11211 SE 82nd, Ave STE. D, Portland, OR 97086
- Phone
- (503) 653-8700
- Fax
- (503) 653-8739
- Mailing address
- 11211 SE 82nd, Ave STE. D, Portland, OR 97266
Registered specialties
Specialist
Primary
Registry record
- NPI
- 1003978610
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 14 Dec 2006
- Record last updated
- 26 Sep 2024
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.