Individual
JOY MICHELLE WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
QMHA
Contact information
Practice address
209 SW FORTH AVE, SUITE 520, PORTLAND, OR 97204-1813
(503) 988-5464
Mailing address
209 SW FORTH AVE, SUITE 520, PORTLAND, OR 97204-1813
(503) 988-5464
(503) 988-4386
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
08/17/2023
Last updated
08/17/2023
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