OWEN WALLULATUM

REDMOND, OR
NPI1265966055
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  17 CRM 065)
Enumeration Date2017-04-18
Last Update Date2017-04-18
Business Address
-- OWEN WALLULATUM CRM
340 NW 5TH ST BOX 1710
REDMOND, OR 97756-1869
Phone number: 541-516-4087
Mailing Address
-- OWEN WALLULATUM CRM
850 SW 4TH ST
MADRAS, OR 97741-9628
Phone number: 541-475-4822
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