Wallace, Dawn
Wallace, Dawn is an individual health care provider with primary practice located at 2074 S 6Th St , Klamath Falls OR 97601-3372. She recently has only one registered license in Other Service Providers / Community Health Worker, which is considered as her primary health care specialty. Wallace, Dawn can be contacted via phone (541) 851-8110.Contact Information
Primary practice address
2074 S 6Th St
Klamath Falls OR 97601-3372
Phone: (541) 851-8110
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Other Service Providers / Community Health Worker | 172V00000X |
Profile Details
| NPI number | 1285332213 |
|---|---|
| LBN Legal business name | Wallace, Dawn |
| Credentials | CHW |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 20th, 2023 |
| Last updated | Feb 20th, 2023 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1285332213 | NPPES |
| Oregon | MEDICAID | R101150 |
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