MR. Evan James Wallace

NPI #1073859351 in Gresham, Oregon

Provider Information

NPI Number
1073859351
Entity Type
Individual
Name
MR. Evan James Wallace
Gender
Not Specified
Sole Proprietor
No
Primary Specialty
Counselor - Mental Health
Enumeration Date
Dec 14, 2012
Last Updated
Dec 14, 2012

Practice Location

Address
360 SW 6TH ST
State
Oregon
ZIP Code
97080-9475
Phone
(503) 726-3806

Specialties & Taxonomy Codes

Specialty
Counselor - Mental HealthMental Health

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