KRISTINA MARIE WALLACE

GRANTS PASS, OR
NPI1417326984
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: OR  PA174747)
Enumeration Date2015-09-15
Last Update Date2020-06-08
Business Address
KRISTINA MARIE WALLACE PA-C
537 UNION AVE SECOND FLOOR
GRANTS PASS, OR 97527-5543
Phone number: 541-479-6777
Mailing Address
KRISTINA MARIE WALLACE PA-C
1115 SE 164TH AVE DEPT 358
VANCOUVER, WA 98683-8004
Phone number: 360-729-1253