Individual
SHARON RENEE WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1258 HIGH ST, EUGENE, OR 97401-3238
(541) 342-8437
Mailing address
1258 HIGH ST, EUGENE, OR 97401-3238
Taxonomy
Speciality
Code
Description
License number
State
175T00000X
Peer Specialist
—
OR
175T00000X
Peer Specialist
Primary
—
—
Other
Enumeration date
06/04/2018
Last updated
11/21/2023
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