IndividualActive
Gail Wilson
NPI 1821205246 · Children's Substance Abuse Rehabilitation Facility · Portland, OR
Provider details
- NPI number
- 1821205246
- Entity type
- Individual
- Primary specialty
- Children's Substance Abuse Rehabilitation FacilityResidential Treatment Facilities
- Sex
- Female
- Sole proprietor
- Yes
- License
- 3245S0500X (OR)
Specialties & taxonomies
Residential Treatment Facilities
Practice location
2614 Se 115th Ave Apt 2
Portland, OR 97266-1176
Phone: (503) 757-4245
Approximate (ZIP-level) locationGet directions
Mailing address
2614 Se 115th Ave Apt 2
Portland, OR 97266-1176
Registry dates
- Enumerated
- 2007-05-16
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.