Wade, Dodi L

Wade, Dodi L is an individual health care provider with primary practice located at 9555 Sw Barnes Rd Suite 301, Portland OR 97225-6663. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Wade, Dodi L can be contacted via phone (503) 535-6338.

Contact Information

Primary practice address
9555 Sw Barnes Rd Suite 301 Portland OR 97225-6663
Phone: (503) 535-6338
Fax: (503) 535-6351
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Pediatrics 363LP0200X 099006377N2 Oregon

Profile Details

NPI number 1023167079
LBN Legal business name Wade, Dodi L
Credentials MSN, PNP
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 9th, 2007
Last updated Jul 8th, 2007 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023167079 NPPES
Oregon MEDICAID 026566

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