MR. CRAIG PHILIP WALLACE


Address: Va Puget Sound, American Lake Division, Tacoma, WA 98493-0001
Phone: 2535828440

MR. CRAIG PHILIP WALLACE (NPI# 1851351522) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1851351522
Entity Type Individual
Full Name MR. CRAIG PHILIP WALLACE
Credential PA-C
Practice Address Va Puget Sound, American Lake Division
Tacoma
WA 98493-0001
Mailing Address Va Puget Sound Health Care System
American Lake Division
Tacoma
WA 98493-0001
Practice Telephone 2535828440
Mailing Telephone 2535828440
Enumeration Date 2006-03-25
Last Update Date 2007-07-11
Gender Code M
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363AM0700X Physician Assistant
Specialization: Medical
PA10003829 WA Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address VA PUGET SOUND, AMERICAN LAKE DIVISION
City TACOMA
State WA
Zip Code 98493-0001

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1508389032 Alina Pechko Optometrist 9600 Veterans Dr Sw Bldg 6, Tacoma, WA 98493 2017-07-17
1720372121 Va Hospital American Lake Rehabilitation Hospital 9600 Veterans Dr., Lakewood, WA 98493 2011-06-02
1326290305 Margaret Elizabeth Johnston-grysho Social Worker 9600 Veterans Dr Sw Bldg 148, Tacoma, WA 98493 2008-10-21
1811195126 Jerry J Thomas Psychiatry & Neurology Va Puget Sound Health Care System, American Lake Divisi, 9600 Veterans Drive Southwest, Buidling 61, Tacoma, WA 98493 2007-07-08
1043372873 Tomi Thompson Dominguez Social Worker 9600 Veteran's Drive Sw Bldg 61 Room 136, Puget Sound Va- American Lake Division, Tacoma, WA 98493 2006-12-15
1669555397 Amor G Carethers Registered Nurse Va Puget Sound Anerican Lake Division, 9600 Veterans Drive, Lake Wood, WA 98493 2006-10-24
1295818144 Kimha Thi Vu Registered Nurse 9600 Veteran Dr., Lakewood, WA 98493 2006-10-23
1952496226 Cathy Ann Sorem Registered Nurse 9600 Veterans Drive A116-r, Bldg. 61a, Room 123, Tacoma, WA 98493 2006-10-04
1831285527 Ann Christine Uppenberg-liedtke Nurse Practitioner Puget Sound Health Care Systems, American Lake, 9600 Veterans Drive, Tacoma, WA 98493 2006-10-04
1972695948 Charlene Howard Social Worker 9600 Veteran Drive, Tacoma, WA 98493 2006-09-28
Find all providers in zip 98493

Taxonomy Information

Taxonomy Code 363AM0700X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Physician Assistant
Specialization Medical

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1407300098 Joshua David Evans Physician Assistant 9040 Jackson Ave Mchj Clq C, Tacoma, WA 98431-1100 2016-08-11
1790177731 Taylor Marquardt Physician Assistant 1624 S I St Ste 305, Tacoma, WA 98405-5093 2015-02-27
1134540909 Otis Lawrence Physician Assistant 608 E 62nd St, Tacoma, WA 98404-1935 2013-12-22
1689905788 Jason F Naylor Physician Assistant 9040 Jackson Avenu, Tacoma, WA 98431-7037 2010-01-29
1952536146 Eric Vangsnes Physician Assistant 9040 Reid St., Attn: Mchj-qcr, Tacoma, WA 98431-1100 2009-05-18
1801048731 Anthony Cee Charles Physician Assistant 1307 Martin Luther King Jr Way, Tacoma, WA 98405-3929 2008-10-22
1083742480 Darin W Smith Physician Assistant 1623 E J St, Tacoma, WA 98421-1602 2007-02-28
1417045857 Kenneth Leo Fleck Physician Assistant 910 Tacoma Ave S, Tacoma, WA 98402-2104 2006-10-11
1912924366 Marthe Butzen Physician Assistant 1708 E. 44th Street, Tacoma, WA 98404 2006-07-15
1013973205 Sheldon Burdell Watson Physician Assistant Madigan Army Medical Center/okubo Clinic, 9040 Jackson Ave, Tacoma, WA 98431-1730 2006-04-25
Find all providers in TACOMA

Competitor

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City TACOMA
Zip Code 98493

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Dataset Information

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.

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