AGUSTINA WALLACE

PORTLAND, OR
NPI1811856339
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy175T00000X Peer Specialist
(Licence: OR  109318)
Enumeration Date2026-01-20
Last Update Date2026-01-20
Business Address
AGUSTINA WALLACE
1132 SW 13TH AVE
PORTLAND, OR 97205-1703
Phone number: 503-535-3860
Mailing Address
AGUSTINA WALLACE
1132 SW 13TH AVE
PORTLAND, OR 97205-1703
Phone number:
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