MRS. Maureen L Wiese, C.PED

NPI #1003978610 in Portland, Oregon

Provider Information

NPI Number: 1003978610
Entity Type: Individual
Name: MRS. Maureen L Wiese, C.PED
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Specialist
Credential: C.PED
Enumeration Date: Dec 14, 2006
Last Updated: Sep 26, 2024

Practice Location

Address: 11211 SE 82ND, AVE
Address 2: STE. D
City: Portland
State: Oregon
ZIP Code: 97086
Phone: (503) 653-8700

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Specialist	174400000X	Primary

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