Wallace, Evan James

Wallace, Evan James is an individual health care provider with primary practice located at 360 Sw 6Th St , Gresham OR 97080-9475. He recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as his primary health care specialty. Wallace, Evan James can be contacted via phone (503) 726-3806.

Contact Information

Primary practice address
360 Sw 6Th St Gresham OR 97080-9475
Phone: (503) 726-3806
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Mental Health 101YM0800X

Profile Details

NPI number 1073859351
LBN Legal business name Wallace, Evan James
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 14th, 2012
Last updated Dec 14th, 2012 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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