Jordan Myungdo Walle
Jordan Myungdo Walle is a Student in an Organized Health Care Education/Training Program in Klamath Falls, Oregon. Practices as a sole proprietor. Licensed in Oregon.
- Licensed in
- OR
- In the registry since
- 2022
- Specialties on file
- 2
Practice location Address checks out
Klamath Falls, ORNo coordinates on file. Search this address in Google Maps
Specialties & licences
| Public Health Dentistry (primary) | Taxonomy 1223D0001X · Licence D11718 (OR) |
|---|---|
| Student in an Organized Health Care Education/Training Program | Taxonomy 390200000X |
Record details
| NPI number | 1780330282 |
|---|---|
| Entity type | Individual (Type 1) |
| Gender | Male |
| Sole proprietor | Yes |
| NPI enumerated | February 23, 2022 |
| Last updated in NPPES | July 30, 2024 |
| Certification date | July 30, 2024 |
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