CHASE E WALLACE

PORTLAND, ME
NPI1699184358
Former NameCHASE E CHARWAT
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363A00000X Physician Assistant
(Licence: CA  55368)
Additional Taxonomies363A00000X Physician Assistant
(Licence: ME  PA1480)
Enumeration Date2014-08-07
Last Update Date2023-05-25
Business Address
Mrs. CHASE E WALLACE PA-C
22 BRAMHALL ST
PORTLAND, ME 04102-3134
Phone number: 207-662-2526
Mailing Address
Mrs. CHASE E WALLACE PA-C
3600 BROADWAY DEPT 41
OAKLAND, CA 94611-5730
Phone number: 310-542-9758