Provider Demographics
NPI:1548762099
Name:WILKINS, TAMERA
Entity Type:Individual
Prefix:
First Name:TAMERA
Middle Name:
Last Name:WILKINS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:421 SW OAK ST
Mailing Address - Street 2:SUITE 250
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97204-1810
Mailing Address - Country:US
Mailing Address - Phone:503-988-5464
Mailing Address - Fax:503-988-4386
Practice Address - Street 1:421 SW OAK ST
Practice Address - Street 2:SUITE 250
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97204-1810
Practice Address - Country:US
Practice Address - Phone:503-988-5464
Practice Address - Fax:503-988-4386
Is Sole Proprietor?:No
Enumeration Date:2018-03-01
Last Update Date:2018-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator