GERALD ADRIAN WALLACE

REDMOND, OR
NPI1265478416
Entity TypeIndividual
GenderMale
Sole Proprietor ?No
Primary Taxonomy163W00000X Registered Nurse
Additional Taxonomies367500000X Nurse Anesthetist, Certified Registered
Enumeration Date2006-06-22
Last Update Date2007-07-08
Business Address
GERALD ADRIAN WALLACE CRNA
1253 NW CANAL BLVD
REDMOND, OR 97756-1334
Phone number: 541-584-8131
Mailing Address
GERALD ADRIAN WALLACE CRNA
PO BOX 4008
PORTLAND, OR 97208-4008
Phone number: 503-372-2740
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