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1033860622
JESSICA WALLACE
LEBANON, OR
NPI
1033860622
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
Yes
Primary Taxonomy
390200000X Student in an Organized Health Care Education/Training Program
Enumeration Date
2022-01-14
Last Update Date
2022-01-14
Business Address
JESSICA WALLACE
200 MULLINS DR
LEBANON, OR 97355-3983
Phone number: 541-259-0235
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Mailing Address
JESSICA WALLACE
200 MULLINS DR
LEBANON, OR 97355-3983
Phone number: 503-703-1727
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