Earnest Wallace III, PSS
Earnest Wallace III, PSS is a Peer Specialist in Portland, Oregon. Practices as a sole proprietor. Licensed in Oregon.
- Licensed in
- OR
- In the registry since
- 2024
Practice location Address checks out
5201 SW Westgate Dr Ste 100Portland, OR 97221-2424
Phone: (469) 297-0096
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Pin is approximate — placed at the ZIP-code centre, not the exact door.
Specialties & licences
| Peer Specialist (primary) | Taxonomy 175T00000X · Licence 111712 (OR) |
|---|
Record details
| NPI number | 1730927815 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Credentials | PSS |
| Sole proprietor | Yes |
| NPI enumerated | July 15, 2024 |
| Last updated in NPPES | July 15, 2024 |
| Certification date | July 15, 2024 |
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