DR. BRIAN EDWARD WALLACE (NPI# 1790017028) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1790017028 |
| Entity Type | Individual |
| Full Name | DR. BRIAN EDWARD WALLACE |
| Credential | M.D. |
| Practice Address |
400 E Pioneer Ave Suite 101 Puyallup WA 98372-3255 |
| Practice Telephone | 2534455828 |
| Mailing Telephone | 2534455828 |
| Enumeration Date | 2010-02-11 |
| Last Update Date | 2016-07-11 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207L00000X | Anesthesiology | MD 60120035 | WA | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1093866121 | Brian Wallace | Dentist | 781 S Lake Dr, Suite 1, Prestonsburg, KY 41653-1340 | 2007-01-16 |
| 1801864350 | Brian Wallace | Internal Medicine | 9005 Kilbride Rd, Baltimore, MD 21236-2017 | 2006-03-10 |
| 1831198811 | Brian David Wallace | Radiology | 1100 Brookhaven Rd, Franklin, KY 42134-2746 | 2005-07-20 |
| 1861939845 | Brian Wallace | Counselor | 7907 Ostrow St Ste F, San Diego, CA 92111-3635 | 2017-01-27 |
| 1114378759 | Brian Charles Wallace | Physician Assistant | 125 W Catawba Ave, Mount Holly, NC 28120-1601 | 2016-06-24 |
| 1154677359 | Brian Venson Wallace | Physical Therapist | 711 Avignon Dr, Ridgeland, MS 39157-5120 | 2012-07-25 |
| 1598083495 | Brian William Wallace | Chiropractor | 139 Morristown Rd, Bernardsville, NJ 07924-2633 | 2010-05-17 |
| 1518118462 | Brian Robert Wallace | Orthopaedic Surgery | 1250 Pine Ridge Rd, Suite 203, Naples, FL 34108-8913 | 2008-10-08 |
| 1518124627 | Brian Scott Wallace | Emergency Medicine | 1200 S Cedar Crest Blvd, Allentown, PA 18103-6202 | 2008-05-18 |
| 1427248350 | Brian J Wallace | Physician Assistant | 325 Princeton Ave, Princeton, NJ 08540-1617 | 2007-07-26 |
| Street Address |
400 E PIONEER AVE SUITE 101 |
| City | PUYALLUP |
| State | WA |
| Zip Code | 98372-3255 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033380894 | Kathleen Herron | Specialist | 400 E Pioneer Ave, Suite 208, Puyallup, WA 98372-3255 | 2008-03-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295371532 | Jeffrey Allen Zhan | Urology | Good Samaritan Medical Office Bldg 1450 5th St Se, Suite 2100- Urology Clinic, Puyallup, WA 98372 | 2019-11-21 |
| 1447811419 | Serenity Counseling & Consulting, LLC | Marriage & Family Therapist | 102 23rd St Se, Unit B, Puyallup, WA 98372 | 2019-06-21 |
| 1316401565 | Katherine Juarez Davidson | Nurse Practitioner | 325 E Pioneer # A145, Puyallup, WA 98372 | 2019-01-22 |
| 1679041404 | Cara Ann Lundin | Nurse Practitioner | 11926 43rd St Crt E, Edgewood, WA 98372 | 2018-11-09 |
| 1104392109 | Megan Black | Occupational Therapist | 40 29th St Ne, Puyallup, WA 98372 | 2018-10-17 |
| 1063919470 | Myriah Shekinah Olakpe | Occupational Therapist | 516 Se 23rd Ave, Puyallup, WA 98372 | 2018-04-11 |
| 1902330202 | Tyler Girdler | Student in an Organized Health Care Education/Training Program | 1322 3rd Street Se Suite 240, Puyallup, WA 98372 | 2017-04-13 |
| 1770039471 | Mahalakshmi Hariharan | Pharmacist | 2117 28th St Se, Puyallup, WA 98372 | 2016-09-01 |
| 1801241112 | Nawazish Ali | Internal Medicine | 401 15th Ave Se Multicare God Samartian Hopsital, Puyallup, WA 98372 | 2016-04-25 |
| 1932567559 | Denice L. Voss | Physical Therapist | 400 29th St. Ne, Puyallup, WA 98372 | 2016-02-10 |
| Find all providers in zip 98372 | ||||
| Taxonomy Code | 207L00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Anesthesiology |
| An anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an operation or an obstetric or diagnostic procedure. The anesthesiologist assesses the risk of the patient undergoing surgery and optimizes the patient's condition prior to, during and after surgery. In addition to these management responsibilities, the anesthesiologist provides medical management and consultation in pain management and critical care medicine. Anesthesiologists diagnose and treat acute, long-standing and cancer pain problems; diagnose and treat patients with critical illnesses or severe injuries; direct resuscitation in the care of patients with cardiac or respiratory emergencies, including the need for artificial ventilation; and supervise post-anesthesia recovery. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Anesthesiology, 2007. http://www.theaba.org/; American Osteopathic Board of Anesthesiology, 2007, http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Anesthesiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Anesthesiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1356444673 | Scott Brian Nelson | Anesthesiology | 400 E Pioneer Ste 208, Puyallup, WA 98372-3257 | 2006-09-06 |
| 1154392405 | Trina M Kleiver | Anesthesiology | 400 E Pioneer Ste 204, Puyallup, WA 98372-3257 | 2006-01-26 |
| 1033192638 | William R Rinker | Anesthesiology | 400 E Pioneer Ste 101, Puyallup, WA 98372-3256 | 2005-11-29 |
| 1770576449 | Robert Forest | Anesthesiology | 400 E Pioneer, Ste 100, Puyallup, WA 98372-3255 | 2005-08-26 |
| 1194723973 | Long D Vu | Anesthesiology | 1322 3rd St Se, Puyallup, WA 98372-3771 | 2005-07-14 |
| 1952783938 | Won Kyun Moon | Anesthesiology | 401 15th Ave Se, Puyallup, WA 98372 | 2015-06-25 |
| 1962778456 | Erica Louise Lilleness | Anesthesiology | 400 E Pioneer Ste 101, Puyallup, WA 98372-3256 | 2012-03-28 |
| 1235422866 | Oumou Toumani Diallo | Anesthesiology | 400 E Pioneer, Puyallup, WA 98372-3255 | 2011-05-16 |
| 1871812941 | Omar Satter | Anesthesiology | 400 E Pioneer, Ste. #101, Puyallup, WA 98372-3255 | 2010-05-27 |
| 1376866335 | Jonathan Martin Deeth | Anesthesiology | 400 E Pioneer Ste 101, Puyallup, WA 98372 | 2010-03-05 |
| Find all providers in PUYALLUP | ||||
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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.