MISS MICHELLE LYNN WALLACE (NPI# 1497091805) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1497091805 |
| Entity Type | Individual |
| Full Name | MISS MICHELLE LYNN WALLACE |
| Credential | LMT |
| Practice Address |
508 Blair Blvd Eugene OR 97402-4630 |
| Mailing Address |
3720 Stewart Rd Eugene OR 97402-5405 |
| Practice Telephone | 5415430290 |
| Mailing Telephone | 5415430290 |
| Enumeration Date | 2012-12-13 |
| Last Update Date | 2012-12-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | 12250 | OR | Other Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1770051252 | Michelle Wallace | Technician | 1515 Sumac Rd, Fort Gibson, OK 74434-7512 | 2018-11-02 |
| 1437524196 | Michelle Wallace | Physical Therapist | 473 Auxier Dr, Cincinnati, OH 45244-2364 | 2015-12-07 |
| 1477808947 | Michelle Wallace | Physical Medicine & Rehabilitation | 75 Norman Pl, Tenafly, NJ 07670-2537 | 2012-07-19 |
| 1598884272 | Michelle Marie Wallace I | Registered Nurse | 17887 State Route 58, Wellington, OH 44090-9464 | 2007-03-27 |
| 1336796374 | Michelle Wallace | Counselor | 369 Ne Revere Ave Ste 101, Bend, OR 97701-4082 | 2019-08-23 |
| 1316471790 | Michelle Dianne Wallace | Nurse Practitioner | 8970 S Meridian St, Indianapolis, IN 46217-5031 | 2017-04-12 |
| 1972044519 | Michelle D Wallace | Durable Medical Equipment & Medical Supplies | 9701 Apollo Dr Ste 100, Largo, MD 20774-4785 | 2017-03-15 |
| 1275938185 | Michelle Mayer Wallace | Pharmacist | 2413 Highway 431 North, Anniston, AL 36206 | 2014-11-04 |
| 1912249822 | Michelle M Wallace | Physical Therapist | 2300 Trenton Rd, Levittown, PA 19056-1423 | 2013-03-19 |
| 1609136266 | Michelle Wallace | Social Worker | 245 E 19th St, Apt. 12f, New York, NY 10003-2639 | 2012-05-16 |
| Street Address |
508 BLAIR BLVD |
| City | EUGENE |
| State | OR |
| Zip Code | 97402-4630 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538709704 | Jordan Charles Smith | Massage Therapist | 775 Menroe St., Eugene, OR 97402 | 2020-01-15 |
| 1104462134 | Cerridwen Laurel Martin | Massage Therapist | 775 Monroe St., Eugene, OR 97402 | 2019-11-25 |
| 1720556368 | Valerie Jeanne Charles | Massage Therapist | 989 Throne Dr., Eugene, OR 97402 | 2018-11-12 |
| 1407324189 | Laura Angulo | Massage Therapist | 1247 W 8th Ave Apt 10, Eugene, OR 97402 | 2018-11-11 |
| 1932687472 | Karl Alan Porter | Counselor | 1195 City View St Ste B, Eugene, OR 97402 | 2018-08-06 |
| 1992283170 | Fresenius Medical Care Dialysis Services - Oregon, LLC | Clinic/Center | 3747 W 11th Ave, Eugene, OR 97402 | 2018-07-31 |
| 1699251744 | Isabella Arlo Jane Silver | Counselor | 970 W 7th Ave., Eugene, OR 97402 | 2018-07-12 |
| 1447740527 | Shasta Tobi Cooke | Behavioral Analyst | 677 1/2 W 12th Ave, Eugene, OR 97402 | 2018-05-15 |
| 1497205306 | Jenna Bracco | Social Worker | 1274 W. 7th Avenue Suite 201, Eugene, OR 97402 | 2016-10-04 |
| 1871041392 | Jeremy Powers | Massage Therapist | 882 Van Buren St, Eugene, OR 97402 | 2016-09-13 |
| Find all providers in zip 97402 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922629328 | Yahsolait Rose | Specialist | 3575 Donald St Ste 170, Eugene, OR 97405-4783 | 2020-04-27 |
| 1740841436 | Lacey Nicole Keeney | Specialist | 1623 Oak St, Eugene, OR 97401-4022 | 2019-06-24 |
| 1356883680 | Jonathan Hall | Specialist | 2866 Crescent Ave Ste 105, Eugene, OR 97408-7423 | 2016-11-17 |
| 1962954537 | Emily Gerrity | Specialist | 3560 Knob Hill Ln, Eugene, OR 97405-4739 | 2016-10-31 |
| 1538528377 | Tami Kanning | Specialist | 3575 Donald St Ste 630, Eugene, OR 97405-4775 | 2016-02-22 |
| 1124485792 | Mind Body Rolfing | Specialist | 1639 Oak St, Suite D, Eugene, OR 97401-4088 | 2016-01-27 |
| 1700257896 | Katie Field | Specialist | 2560 Alder St, Eugene, OR 97405-3032 | 2015-10-14 |
| 1619346533 | Heidi Holcomb | Specialist | 390 W 27th Pl, Eugene, OR 97405-2749 | 2015-09-21 |
| 1407230980 | Tyson Lancaster | Specialist | 1545 Villard St, Eugene, OR 97403-2045 | 2015-07-15 |
| 1699182048 | Alexandra Fraga | Specialist | 224 W 37th Ave, Eugene, OR 97405-3312 | 2014-07-17 |
| Find all providers in EUGENE | ||||
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| 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.