Wallace, Laurel Lynn

Wallace, Laurel Lynn is an sole proprietor health care provider with primary practice located at 606 Medical Pky , Enterprise OR 97828. She recently has 2 registered licenses in different health care specialties including Other Service Providers / Peer Specialist, Other Service Providers / Case Manager/Care Coordinator. Other Service Providers / Peer Specialist is her primary health care specialty. Wallace, Laurel Lynn can be contacted via phone (541) 426-4524.

Contact Information

Primary practice address
606 Medical Pky Enterprise OR 97828
Phone: (541) 426-4524
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Peer Specialist 175T00000X
Other Service Providers / Case Manager/Care Coordinator 171M00000X

Profile Details

NPI number 1881337319
LBN Legal business name Wallace, Laurel Lynn
Credentials
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 13th, 2022
Last updated Aug 8th, 2022 - about 4 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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