Individual
KARI ANN WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4360 SE HARBORTON ST, SOUTH BEACH, OR 97366-9696
(541) 270-8919
Mailing address
PO BOX 52, NEWPORT, OR 97365-0005
(541) 270-8919
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
—
Other
Enumeration date
08/31/2023
Last updated
08/31/2023
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