Provider Demographics
NPI:1972922805
Name:WYNNE SOLUTIONS, L.L.C.
Entity Type:Organization
Organization Name:WYNNE SOLUTIONS, L.L.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:GILMOUR
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:805-804-7563
Mailing Address - Street 1:9318 N POLK AVE
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97203-2324
Mailing Address - Country:US
Mailing Address - Phone:805-804-7563
Mailing Address - Fax:
Practice Address - Street 1:9318 N POLK AVE
Practice Address - Street 2:
Practice Address - City:PORTLAND
Practice Address - State:OR
Practice Address - Zip Code:97203-2324
Practice Address - Country:US
Practice Address - Phone:805-804-7563
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-04-08
Last Update Date:2014-04-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Multi-Specialty