| Wild Wish Counseling Llc | |
|
12725 Sw Millikan Way Ste 300 Beaverton OR 97005-1687 | |
| (503) 906-7945 | |
| Not Available |
| Full Name | Wild Wish Counseling Llc |
|---|---|
| Speciality | Counselor |
| Location | 12725 Sw Millikan Way Ste 300, Beaverton, Oregon |
| Authorized Official Name and Position | Wendy Esther (OWNER) |
| Authorized Official Contact | 5039067945 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Wild Wish Counseling Llc 12725 Sw Millikan Way Ste 300 Beaverton OR 97005-1687 Ph: (503) 906-7945 | Wild Wish Counseling Llc 12725 Sw Millikan Way Ste 300 Beaverton OR 97005-1687 Ph: (503) 906-7945 |
| NPI Number | 1548845563 |
|---|---|
| Provider Enumeration Date | 03/11/2021 |
| Last Update Date | 03/11/2021 |
| Certification Date | 03/11/2021 |
| Medicare PECOS PAC ID | 2466896295 |
|---|---|
| Medicare Enrollment ID | O20240220001727 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1548845563 | NPI | - | NPPES |
| Provider Name | Wendy Ellis Esther |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609235811 PECOS PAC ID: 9638513468 Enrollment ID: I20240220001931 |
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