THE WALLACE MEDICAL CONCERN
Organization (NPI-2)
Active
Nurse Practitioner, Family
Provider Information
- NPI Number
1215390109- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 254 NW BURNSIDE ROAD, GRESHAM, OR, 97030
- Phone
- (503) 489-1760
Specialties & Taxonomies
Nurse Practitioner, Family
Primary
All Addresses
MAILING
254 NW BURNSIDE ROAD
GRESHAM, OR, 97030