Most Relevant Information
Provider Data
| NPI Number: | 1003225368 |
| Provider Name: | JESSICA ANN WILSON |
| Entity Type: | Individual |
| Taxonomy Code: | 104100000X |
| Specialty: | Social Worker |
| License Number: |
Most Important Dates
| Enumeration Date: | 08/11/2014 |
| Last Updated: | 08/11/2014 |
Provider Practice Location
9830 NE CASCADES PKWY
STE 200
PORTLAND
OR
972206832
Practice Location Phone/Fax
| Phone: | 9712711807 |
| Fax: |
Provider Mailing Location
9830 NE CASCADES PKWY
STE 200
PORTLAND
OR
972206832
Provider Mailing Phone/Fax
| Phone: | |
| Fax: |