NPI 1821205246

Gail Renee Wilson

Practitioner Children's Substance Abuse Rehabilitation Facility Portland, OR

Practice location

Address: 2614 SE 115th Ave APT 2, Portland, OR 97266-1176
Phone: (503) 757-4245

Registered specialties

Children's Substance Abuse Rehabilitation Facility Primary

Residential Treatment Facilities Taxonomy 3245S0500X Licence 3245S0500X (OR)

Other Substance Abuse Rehabilitation Facility providers in Oregon →

Registry record

NPI: 1821205246
Entity type: Individual
Sex (as registered): Female
NPI issued: 16 May 2007
Record last updated: 8 Jul 2007

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.