MR. EVAN WALLACE

Counselor - Mental Health

Active Individual
NPI: 1073859351

Practice Address

360 SW 6TH ST
Gresham, OR 97080

Phone: (503) 726-3806

Specialties

Specialty Code Primary License
Counselor - Mental Health 101YM0800X Yes -

Frequently Asked Questions

NPI 1073859351 is the National Provider Identifier for MR. EVAN WALLACE, a Counselor - Mental Health provider located in Gresham, OR. This NPI was enumerated on December 14, 2012.
MR. EVAN WALLACE practices at 360 SW 6TH ST, Gresham, OR 97080.

Quick Facts

NPI
1073859351
Type
Individual
Enumerated
Dec 14, 2012
Last Updated
Dec 14, 2012

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