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Individual

AUSTIN WALLER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
550 NW FRANKLIN AVE STE 228, BEND, OR 97703-2892
(541) 516-6330
Mailing address
550 NW FRANKLIN AVE STE 228, BEND, OR 97703-2892

Taxonomy

Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
Primary

Other

Enumeration date
05/06/2025
Last updated
05/06/2025
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