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Mr. Evan James Wallace
Mental Health Counselor in Gresham, Oregon
NPI 1073859351

Evan James Wallace is a Mental Health Counselor based in Tigard, OR and is specialized in Mental Health. Evan James Wallace practices in Gresham, OR. The NPI Number for Evan James Wallace is 1073859351 and holds a License No. (Oregon).

The current practice location address for Evan James Wallace is 360 Sw 6Th St, Gresham, OR and can be reached out via phone at 503-726-3806.

Location: 360 Sw 6Th St, Gresham, OR, 97223
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1073859351
Provider Name
Evan James Wallace
Credential
Provider Entity Type
Individual
Gender
Male
Address
360 Sw 6Th St, Gresham, OR, 97223
Phone Number
503-726-3806
Fax Number
Provider Enumeration Date
12/14/2012
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
360 Sw 6Th St
City
Gresham
State
Oregon
Zip
97080-9475
Phone Number
503-726-3806
Fax Number
person
Provider Business Mailing Address Details
Address
360 Sw 6Th St
City
Gresham
State
Oregon
Zip
97080-9475
Phone Number
503-726-3806
Fax Number
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Mental Health
Taxonomy
101YM0800X
License No.
()
Definition
Definition to come...
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