Healthcare Provider Details

I. General information

NPI: 1437388261
Provider Name (Legal Business Name): WENDY J. LINKER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/14/2009
Last Update Date: 07/14/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

17685 65TH AVE STE 300
LAKE OSWEGO OR
97035-7800
US

IV. Provider business mailing address

16869 65TH AVE # 293
LAKE OSWEGO OR
97035-7865
US

V. Phone/Fax

Practice location:
  • Phone: 503-624-3929
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084A0401X
TaxonomyAddiction Medicine (Psychiatry & Neurology) Physician
License Number20332
License Number StateOR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: