ROHN DALE WALLACE (NPI# 1467480939) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467480939 |
| Entity Type | Individual |
| Full Name | ROHN DALE WALLACE |
| Credential | SUBMARINE IDC |
| Practice Address |
Uss Ohio Ssgn 726 Gold Silverdale WA 98312 |
| Mailing Address |
4417 Waterman Ridge Ln E Port Orchard WA 98366-8001 |
| Practice Telephone | 3604768351 |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1710I1002X |
Military Health Care Provider Specialization: Independent Duty Corpsman |
Other Service Providers |
| Street Address |
USS OHIO SSGN 726 GOLD |
| City | SILVERDALE |
| State | WA |
| Zip Code | 98312 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962025114 | Candace Mckenzie | Counselor | 2564 Cascades Pass Blvd, The Landings Bldg. 779, Bremerton, WA 98312 | 2020-05-22 |
| 1710473590 | Sandra Louise Walker | Family Medicine | 14301 Nw Coho Run, Bremerton, WA 98312 | 2018-07-05 |
| 1467947663 | Jason David Alexander | Military Health Care Provider | Uss Kentucky, Ssbn, Fpo, AE 98312 | 2018-06-29 |
| 1588176614 | Institute Family for Development | Community/Behavioral Health | 5610 Kitsap Way, Suite 315, Bremerton, WA 98312 | 2017-10-30 |
| 1720521321 | Debra Lynn Lemieux | Counselor | 5762 Chico Way Nw, Bremerton, WA 98312 | 2016-11-30 |
| 1164840047 | Amber Rose Morison | Chiropractor | 3963 Sand Dollar Road West, Bremerton, WA 98312 | 2014-03-28 |
| 1942625611 | Kristen Williams | Clinic/Center | 5112 Nw Taylor Rd., Bremerton, WA 98312 | 2014-03-04 |
| 1184049629 | Tariku Tsegaye Messele | Specialist/Technologist | 5112 Nw Taylor Road, Bremerton, WA 98312 | 2014-02-20 |
| 1063784064 | Johnson Chiropractic Clinic | Clinic/Center | 3721 Kitsap Way Suite #8, Bremerton, WA 98312 | 2012-02-06 |
| 1194013532 | Casey Mccann | Student in an Organized Health Care Education/Training Program | 1 Boone Rd., Naval Hospital Bremerton, Bremerton, WA 98312 | 2011-07-19 |
| Find all providers in zip 98312 | ||||
| Taxonomy Code | 1710I1002X |
| Grouping | Other Service Providers |
| Classification | Military Health Care Provider |
| Specialization | Independent Duty Corpsman |
| A Navy Independent Duty Corpsman (IDC) is an active duty Sailor who has successfully completed one of the Navy's specific IDC training programs. IDCs are formally trained and educated to perform primary medical care and minor surgical services in a variety of health care and non-health care settings worldwide under indirect physician supervision. IDCs provide care to Department of Defense operational forces and other supporting forces such as contractors and foreign nationals. |
| Notes: Source: Bureau of Medicine and Surgery, Department of the Navy [7/1/2005: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669022810 | Shannon Dawkins | Military Health Care Provider | 2150 Thresher Ave, Silverdale, WA 98315-2103 | 2019-09-18 |
| 1649830779 | Monica Yineman | Military Health Care Provider | 9812 Enchantment Ave Nw, Silverdale, WA 98383-8822 | 2019-06-20 |
| 1326521097 | Elizabeth Nicole Sifuentes | Military Health Care Provider | Uss Michigan- Commander Sub Group Nine, 2150 Thresher Ave, Silverdale, WA 98315-2150 | 2018-09-10 |
| 1700062593 | Jason Schwieterman | Military Health Care Provider | 2200 Scorpion Ave, Silverdale, WA 98315-2201 | 2008-01-11 |
| 1639353501 | Julius Clayton Mclinko | Military Health Care Provider | 2102 Drum St, Silverdale, WA 98315-2100 | 2007-12-27 |
| 1538191283 | Matthew H Mcclernan | Military Health Care Provider | Uss Kentucky Ssbn 737 Gold, 2100 Thresher Ave, Silverdale, WA 98315 | 2006-07-06 |
| 1922039247 | Ronald Lee Hampton | Military Health Care Provider | 7111 Sealion Rd, Silverdale, WA 98315-7102 | 2006-07-05 |
| 1326077561 | Denfield Arnaldo Thomas | Military Health Care Provider | 4108 Michigan Dr Apt A, Silverdale, WA 98315-9427 | 2006-07-01 |
| 1770527962 | Patrick Blake West | Military Health Care Provider | Uss Louisiana Ssbn 743 (blue), 2100 Thresher Ave, Silverdale, WA 98315-2100 | 2006-06-16 |
| 1679514392 | Bernard H Agnew | Military Health Care Provider | 2100 Thresher Ave, Uss Maine Ssbn 741 Blue, Silverdale, WA 98315-2103 | 2006-06-10 |
| Find all providers in SILVERDALE | ||||
| City | SILVERDALE |
| Zip Code | 98312 |
Please comment or provide details below to improve the information on ROHN DALE WALLACE.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.