Individual
TAWAYNE NOLEN MALONE JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
0615 SW PALATINE HILL ROAD, TAWAYNE MALONE - MSC 2159, PORTLAND, OR 97219
(916) 868-5787
Mailing address
0615 SW PALATINE HILL ROAD, TAWAYNE MALONE - MSC 2159, PORTLAND, OR 97219
Taxonomy
Speciality
Code
Description
License number
State
103T00000X
Psychologist
Primary
—
—
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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