Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 225XP0019X | Occupational Therapist - Physical Rehabilitation | 1061958 | OR |
NPI | 1154744225 |
---|---|
Provider Name | Dawn Wedell |
First Address | Milwaukie, OR 97222-4628 |
Second Address | Portland, OR 97233-6105 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/01/2014 |
Last Update Date | 27/01/2014 |