MIKE WALLACE

DALLAS, OR
NPI1881413680
Entity TypeIndividual
GenderMale
Sole Proprietor ?Yes
Primary Taxonomy175T00000X Peer Specialist
(Licence: OR  2627)
Enumeration Date2024-10-08
Last Update Date2024-10-08
Business Address
MIKE WALLACE
945 SE UGLOW AVE
DALLAS, OR 97338-2642
Phone number: 503-837-1762
Mailing Address
MIKE WALLACE
1170 BARNES AVE SE APT 222
SALEM, OR 97306-3560
Phone number: 503-949-1008
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