Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. THEODORE WILLIAM WALLACE, PA-C
Active Sole ProprietorMR. THEODORE WILLIAM WALLACE, PA-C is a Physician Assistant healthcare provider located in TACOMA, Washington. NPI 1609931393 is currently active in the NPPES registry. Verify at CMS.
Physician Assistant · TACOMA, WA
Registration Details
- NPI Number
- 1609931393
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 25, 2006 (19.660756758756 yrs)
- Last Updated
- Jul 8, 2007
- License
-
PA100003556 (WA)
- Sole Proprietor
- Yes
Practice Information
- Address
-
MADIGAN ARMY MEDICAL CTR9040A FITZSIMMONS DRTACOMA, WA, 984310001Browse WA providers · Browse ZIP 98431
- Phone
- 2539685161
- Primary Specialty
-
Physician Assistant
363A00000X
Other Physician Assistant Providers in TACOMA, WA
| Name | Credential | NPI |
|---|---|---|
| NOELLE M EGGE | PA-C | 1508861709 |
| ERIN M LENZA | PAC | 1285635490 |
| CATHERINE A HARTJOY | PAC | 1275520066 |
| MR. GEORGE NATHAN WISE | PA-C | 1366433542 |
| TRACEY LYNN WILCOX | PA-C | 1881675015 |
| MR. JOHN BARTON GILLUM JR. | PA | 1699752451 |
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.