person
Kimberly Wallace, CADC1
Addiction (Substance Use Disorder) Counselor in Portland, Oregon
NPI 1942592340

Kimberly Wallace is an Addiction (Substance Use Disorder) Counselor based in Portland, OR and is specialized in Addiction (Substance Use Disorder). Kimberly Wallace practices in Portland, OR and has the professional credentials of CADC1. The NPI Number for Kimberly Wallace is 1942592340 and holds a License No. 140414 (Oregon).

The current practice location address for Kimberly Wallace is 1427 Se 182Nd Ave, Portland, OR and can be reached out via phone at 971-202-7851 and via fax at 503-206-7164.

Location: 1427 Se 182Nd Ave, Portland, OR, 97233-5008
person
Provider Profile Details
NPI Number
1942592340
Provider Name
Kimberly Wallace
Credential
CADC1
Provider Entity Type
Individual
Gender
Female
Address
1427 Se 182Nd Ave, Portland, OR, 97233-5008
Phone Number
971-202-7851
Fax Number
503-206-7164
Provider Enumeration Date
05/04/2011
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
1427 Se 182Nd Ave
City
State
Zip
97233-5008
Phone Number
971-202-7851
Fax Number
503-206-7164
person
Provider Business Mailing Address Details
Address
1427 Se 182Nd Ave
City
State
Zip
97233-5008
Phone Number
971-202-7851
Fax Number
503-206-7164
person
Provider's Taxonomy Details 1
Type
Behavioral Health & Social Service Providers
Classification
Counselor
Speciality
Addiction (Substance Use Disorder)
Taxonomy
License No.
140414 (Oregon)
Definition
Definition to come...
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