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General NPI Number Information
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NPI Number | 1982159489
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Entity Type | Individual
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Provider Name | PATRCIA WILSON MA, LMFT
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Gender | Female
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Dates
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Enumeration Date | 08/24/2016
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Last Update Date | 04/15/2025
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Provider Practice Location Address
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Address Line | 200 E FOOTHILLS DR
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City | NEWBERG
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State | OR
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Zip | 97132-9039
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Country | US
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Telephone | 971-412-4052
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Fax |
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Provider Business Mailing Address
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Address Line | 1002A N SPRINGBROOK RD STE 314
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City | NEWBERG
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State | OR
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Zip | 97132-2024
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Country | US
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Telephone | 971-412-0452
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Fax | 971-231-0235
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | T2401
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License Number State | OR
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