Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
CAROL ANN WALLACE, MD
Active Sole ProprietorCAROL ANN WALLACE, MD is a Health Maintenance Organization healthcare provider located in CLACKAMAS, Oregon. NPI 1639272412 is currently active in the NPPES registry. Verify at CMS.
Health Maintenance Organization · CLACKAMAS, OR
Registration Details
- NPI Number
- 1639272412
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Sep 6, 2006 (19.907127344768 yrs)
- Last Updated
- Jul 8, 2007
- License
-
MD14314 (OR)
- Sole Proprietor
- Yes
Practice Information
- Address
-
10180 SE SUNNYSIDE RDCLACKAMAS, OR, 970158970Browse OR providers · Browse ZIP 97015
- Phone
- 5036522880
- Primary Specialty
-
Health Maintenance Organization
302R00000X
Other Health Maintenance Organization Providers in CLACKAMAS, OR
| Name | Credential | NPI |
|---|---|---|
| WENDY L. MEDNICK | M.D. | 1487667887 |
| ALF EDWARD WYLLER | M.D. | 1346336120 |
| MR. DAVID GREGORY PLEIMAN | LCSW, MSW | 1265684955 |
| MARIKO APRIL ONO | — | 1801126032 |
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.