DoctorDataHub
Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

JORDAN SCOTT WALLACE, MD

Active

JORDAN SCOTT WALLACE, MD is a Pediatrics healthcare provider located in SNOQUALMIE, Washington. NPI 1780210658 is currently active in the NPPES registry. Verify at CMS.

Pediatrics · SNOQUALMIE, WA

Registration Details

NPI Number
1780210658
Provider Type
Individual
Gender
Male
NPI Issued
Mar 22, 2020 (6.428977594208 yrs)
Last Updated
Oct 15, 2025
License
MD61570069 (WA)

Practice Information

Address
9801 FRONTIER AVE SE
SNOQUALMIE, WA, 980655200
Browse WA providers · Browse ZIP 98065
Phone
4258312300
Primary Specialty
Pediatrics
208000000X

Other Pediatrics Providers in SNOQUALMIE, WA

Name Credential NPI
HEMA NIRMAL MD 1043468028
DR. NEETA JAIN M.D. 1659674687
DR. CHINONYELUM BLESSING OBIH MD 1174918965
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.