Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. JARED LEE WALLACE, PA-C
ActiveMR. JARED LEE WALLACE, PA-C is a Physician Assistant healthcare provider located in KENAI, Alaska. NPI 1063746667 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · KENAI, AK
Registration Details
- NPI Number
- 1063746667
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Sep 29, 2009 (16.917195187135 yrs)
- Last Updated
- Mar 7, 2023
Practice Information
- Address
-
43783 KENAI SPUR HWYKENAI, AK, 99611Browse AK providers · Browse ZIP 99611
- Phone
- 9072839116
- Fax
- 9072839122
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in KENAI, AK
| Name | Credential | NPI |
|---|---|---|
| MS. RENE' D. KENNEY | RN, PA-C | 1124001516 |
| MARK VICTOR RESTAD | PA-C | 1114145174 |
| MR. MARK R MENCEL | PA-C | 1417257908 |
| ROBERT VERNON MCRORIE JR. | — | 1972906899 |
| SARAH ASHLEY KURKA | PA-C | 1649167453 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.