Individual
JACQUELINE VASQUEZ WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1015 SE MILLER ST, PORTLAND, OR 97202-6380
(503) 888-2114
Mailing address
1015 SE MILLER ST, PORTLAND, OR 97202-6380
(503) 888-2114
Taxonomy
Speciality
Code
Description
License number
State
171R00000X
Interpreter
Primary
—
—
Other
Enumeration date
07/09/2021
Last updated
07/09/2021
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