CYNTHIA WALLACE

MEDFORD, OR
NPI1811393648
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363LG0600X Nurse Practitioner, Gerontology
(Licence: OR  201500016NP-PP)
Enumeration Date2014-11-05
Last Update Date2020-09-30
Business Address
Mrs. CYNTHIA WALLACE AGPCNP
1111 CRATER LAKE AVE
MEDFORD, OR 97504-6241
Phone number: 541-732-5250
Mailing Address
Mrs. CYNTHIA WALLACE AGPCNP
PO BOX 3308
PORTLAND, OR 97208-3308
Phone number: 541-732-5250