MIKE WALLACE

Peer Specialist

Active Individual
NPI: 1881413680

Practice Address

945 SE UGLOW AVE
Dallas, OR 97338

Phone: (503) 837-1762

Specialties

Specialty Code Primary License
Peer Specialist 175T00000X Yes 2627 (OR)

Frequently Asked Questions

NPI 1881413680 is the National Provider Identifier for MIKE WALLACE, a Peer Specialist provider located in Dallas, OR. This NPI was enumerated on October 8, 2024.
MIKE WALLACE practices at 945 SE UGLOW AVE, Dallas, OR 97338.

Quick Facts

NPI
1881413680
Type
Individual
Enumerated
Oct 8, 2024
Last Updated
Oct 8, 2024

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