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1265966055
OWEN WALLULATUM
REDMOND, OR
NPI
1265966055
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YA0400X Counselor Addiction (Substance Use Disorder)
(Licence: OR 17 CRM 065)
Enumeration Date
2017-04-18
Last Update Date
2017-04-18
Business Address
OWEN WALLULATUM CRM
340 NW 5TH ST BOX 1710
REDMOND, OR 97756-1869
Phone number: 541-516-4087
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Mailing Address
OWEN WALLULATUM CRM
850 SW 4TH ST
MADRAS, OR 97741-9628
Phone number: 541-475-4822
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