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1730927815
EARNEST WALLACE
PORTLAND, OR
NPI
1730927815
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
175T00000X Peer Specialist
(Licence: OR 111712)
Enumeration Date
2024-07-15
Last Update Date
2024-07-15
Business Address
EARNEST WALLACE PSS
5201 SW WESTGATE DR STE 100
PORTLAND, OR 97221-2424
Phone number: 469-297-0096
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Mailing Address
EARNEST WALLACE PSS
423 MCKINLEY ST
CEDAR HILL, TX 75104-2287
Phone number:
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