| Wallace | |
|
18139 Ne Couch Street Portland OR 97230 | |
| (503) 489-1760 | |
| Not Available |
| Full Name | Wallace |
|---|---|
| Speciality | Clinic/center - Primary Care |
| Location | 18139 Ne Couch Street, Portland, Oregon |
| Authorized Official Name and Position | Stuart Currie (CMO) |
| Authorized Official Contact | 5034891760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Wallace 18139 Ne Couch Street Portland OR 97230 Ph: () - | Wallace 18139 Ne Couch Street Portland OR 97230 Ph: (503) 489-1760 |
| NPI Number | 1215390091 |
|---|---|
| Provider Enumeration Date | 03/30/2016 |
| Last Update Date | 02/24/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1215390091 | NPI | - | NPPES |
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