Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 103TR0400X | Rehabilitation Psychologist | 2674 | OR |
NPI | 1467730697 |
---|---|
Provider Name | Dr. Rebecca Christine Wilbur |
First Address | Portland, OR 97210-3025 |
Second Address | Portland, OR 97210-3025 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/07/2011 |
Last Update Date | 27/07/2021 |