MR. EVAN WALLACE
Counselor - Mental Health
Active
Individual
NPI: 1073859351
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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