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Individual

WENDI MARIE WALLACE

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
OTR/L

Contact information

Practice address
10180 SE SUNNYSIDE RD, CLACKAMAS, OR 97015-8970
(503) 652-2880
Mailing address
1162 NW 22ND AVE, CAMAS, WA 98607-7979
(360) 833-8327

Taxonomy

Speciality
Code
Description
License number
State
225X00000X
Occupational Therapist
Primary
1023437
OR
225X00000X
Occupational Therapist
OT00003555
WA

Other

Enumeration date
08/21/2006
Last updated
07/08/2007
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