Healthcare Provider Details

I. General information

NPI: 1871449801
Provider Name (Legal Business Name): NATHAN LOUIS GRIFFEL WILD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/10/2026
Last Update Date: 03/10/2026
Certification Date: 03/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 51
HOOD RIVER OR
97031-0002
US

IV. Provider business mailing address

PO BOX 51
HOOD RIVER OR
97031-0002
US

V. Phone/Fax

Practice location:
  • Phone: 541-575-0237
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: