Provider Demographics
NPI:1679964605
Name:WIKEL, JAMES
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:
Last Name:WIKEL
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1103 S SPRING ST
Mailing Address - Street 2:
Mailing Address - City:GROVE
Mailing Address - State:OK
Mailing Address - Zip Code:74344-2834
Mailing Address - Country:US
Mailing Address - Phone:425-312-8334
Mailing Address - Fax:
Practice Address - Street 1:1011 COMMERCIAL ST NE STE 110
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97301-1036
Practice Address - Country:US
Practice Address - Phone:503-983-9900
Practice Address - Fax:503-983-9899
Is Sole Proprietor?:No
Enumeration Date:2015-02-12
Last Update Date:2023-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175T00000XOther Service ProvidersPeer Specialist