Individual
ANNE WALLIS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
13007 NE GLISAN ST, PORTLAND, OR 97230-2545
(503) 215-7850
Mailing address
4531 SE BELMONT ST STE 100, PORTLAND, OR 97215-1675
(503) 215-6556
Taxonomy
Speciality
Code
Description
License number
State
163WH0200X
Home Health Registered Nurse
Primary
201406034RN
OR
Other
Enumeration date
10/08/2018
Last updated
10/08/2018
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