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1396913331
JASON DAVID WALLIS
PORTLAND, OR
NPI
1396913331
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
101YP2500X Counselor, Professional
(Licence: OR C7443)
Enumeration Date
2008-02-12
Last Update Date
2024-09-05
Business Address
JASON DAVID WALLIS LPC
2901 E BURNSIDE ST
PORTLAND, OR 97214-1831
Phone number: 503-953-0310
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Mailing Address
JASON DAVID WALLIS LPC
3500 NE MARTIN LUTHER KING JR BLVD STE 200
PORTLAND, OR 97212-2093
Phone number: 503-655-8264
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