Earnest Wallace, PSS

NPI 1730927815 · on the registry since 2024 · sole proprietor

Practice

Address: 5201 Sw Westgate Dr Ste 100
Portland, OR 97221
Phone: (469) 297-0096
Organisation at this address: Jocelyn Kirnak, Inc.
Renew Family Medicine Llc
Northwest Lice Centers Inc
Stephanie K Farrell Nd, Llc
Corehealth Behavioral Health
Inferred from a shared address, not stated in the registry.
Clinicians at this address: 8

Registry record

Primary taxonomy: 175T00000X
175T00000X
Licence states on file: OR
From the registry's licence fields, which are often incomplete.
Sex: Male
Record last updated: 2024-07-15

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon