Jennifer Lyn Wallace in Portland - Family Medicine
Jennifer Lyn Wallace - NPI 1730154154
Jennifer Lyn Wallace is a Family Medicine in Portland, Oregon. Jennifer Lyn Wallace practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Jennifer Lyn Wallace is 1730154154. The last update date is 2008-03-18.
Jennifer Lyn Wallace's current location address is 1235 Se Division St, Portland, Oregon. You can contact this provider via phone number 8884801115. The mailing address for Jennifer Lyn Wallace is 1235 Se Division St, Portland, Oregon. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Jennifer Lyn Wallace |
|---|---|
| Address | 1235 Se Division St, Portland, Oregon |
| Phone Number | 8884801115 |
| Fax Number | |
| Sole Proprietor | Y |
| Credentials | MD |
NPI Number Detail
| NPI Number | 1730154154 |
|---|---|
| Provider Enumeration Date | 2006-02-20 |
| Last Updated Date | 2008-03-18 |
Provider Mailing Address Detail
| Address | 1235 Se Division St |
|---|---|
| City | Portland |
| State | Oregon (OR) |
| Post Code | 972021099 |
| Phone Number | 8884801115 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | MD24427 |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 232919 | OR | -- |
Post Comment/ Review Below
What is the unique identifier code issued to Jennifer Lyn Wallace by the Centers for Medicare & Medicaid Services (CMS)?
The Jennifer Lyn Wallace has been assigned the NPI (National Provider Identifier) 1730154154. This 10-digit code serves as a unique identification number for healthcare providers, issued by the CMS.
Could you please provide the complete street address where Jennifer Lyn Wallace is physically located?
The Jennifer Lyn Wallace is physically situated at the following address: 1235 Se Division St, Portland, OR, 972021099.
What is the area of specialization for Jennifer Lyn Wallace, and what is the corresponding taxonomy classification code for this field?
The specialized field of practice for Jennifer Lyn Wallace is Family Medicine, and the corresponding taxonomy code that categorizes this area of expertise is 207Q00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1730154154 to Jennifer Lyn Wallace?
The Jennifer Lyn Wallace received its 1730154154 assignment from the Centers for Medicare & Medicaid Services on 2006-02-20.
When was the information pertaining to Jennifer Lyn Wallace most recently updated or revised?
The details related to Jennifer Lyn Wallace, including its address, specialty, and other relevant information, were last updated or revised on 2008-03-18.