Individual
MR. WESLEY W WALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DC
Contact information
Practice address
13430 SW SARATOGA LN, BEAVERTON, OR 97008-7602
(503) 250-0914
Mailing address
13430 SW SARATOGA LN, BEAVERTON, OR 97008-7602
(503) 250-0914
Taxonomy
Speciality
Code
Description
License number
State
111N00000X
Chiropractor
Primary
N/A
OR
Other
Enumeration date
09/23/2011
Last updated
09/23/2011
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