CLAUDETTE F WALLACE

PORTLAND, OR
NPI1568713386
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy101YA0400X Counselor, Addiction (Substance Use Disorder)
(Licence: OR  90-09-02)
Enumeration Date2012-09-20
Last Update Date2012-09-20
Business Address
-- CLAUDETTE F WALLACE CADC III
1949 SE 122ND AVE
PORTLAND, OR 97233-1303
Phone number: 971-271-6313
Mailing Address
-- CLAUDETTE F WALLACE CADC III
232 NW 6TH AVE
PORTLAND, OR 97209-3609
Phone number: 971-271-6313
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