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Contact Information

JORDAN M WALLE
2074 S 6TH ST
KLAMATH FALLS, OR97601-3372
 Phone: 541-851-8110
 Fax:
 Website:
Indicates primary specialty

NPI Profile & details for JORDAN M WALLE · (Male)

NPI # 1780330282
Status Active
Credentials
Entity Individual
Enumeration date 02/23/2022
Last updated 07/30/2024 - More than a year ago
Sole proprietor 1 Yes
Identifiers
  • OR License # D11718
  • OR Medicaid 500822026
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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