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1235600529
MICHAEL WALL
PORTLAND, OR
NPI
1235600529
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
172V00000X Community Health Worker
Enumeration Date
2018-12-11
Last Update Date
2018-12-11
Business Address
MICHAEL WALL
847 NE 19TH AVE STE 100
PORTLAND, OR 97232-2684
Phone number: 503-238-0769
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Mailing Address
MICHAEL WALL
PO BOX 8459
PORTLAND, OR 97207-8459
Phone number:
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