Wildwood Health and Wellness

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

WILDWOOD HEALTH AND WELLNESS

Practice address

16100 NW Cornell Rd Ste 220
Beaverton, OR 97006-7334

Phone

(303) 929-8993

NPI assigned

Dec 9, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Allison Renee Rott, PA-C

Title

Physician Assistant

Phone

(303) 929-8993

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1607472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1608681600000",
    "number": "1013513472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4906 NE CLEVELAND AVE",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972112718",
            "telephone_number": "303-929-8993"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16100 NW CORNELL RD STE 220",
            "city": "BEAVERTON",
            "state": "OR",
            "postal_code": "970067334",
            "telephone_number": "303-929-8993"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILDWOOD HEALTH AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-12-09",
        "last_updated": "2020-12-23",
        "certification_date": "2020-12-23",
        "status": "A",
        "authorized_official_last_name": "ROTT",
        "authorized_official_first_name": "ALLISON",
        "authorized_official_middle_name": "RENEE",
        "authorized_official_title_or_position": "PHYSICIAN ASSISTANT",
        "authorized_official_telephone_number": "303-929-8993",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "2084N0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Psychiatry & Neurology, Neurology",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Nicole Wilbourn, CNM
• Payton Wilcox
• Wild Mountain Medicine LLC
• Wild Wish Counseling LLC
• Jonathan Douglas Wildi, M.D.
• Wildwood Psychiatric Resource Center
• Suzanne Wilhour
• Gerald Stanley Wilk Jr.
• Ashley Wilkins, LCSW
• Denise Wilkinson, O.D.

• Family Medicine Physician in Beaverton, OR
• Providers in Beaverton, OR by specialty
• Family Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.