DR. PRISCILLA JANE WALLACE (NPI# 1932210069) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1932210069 |
| Entity Type | Individual |
| Full Name | DR. PRISCILLA JANE WALLACE |
| Other Name | DR. PRISCILLA W ALEXANDER |
| Credential | MD |
| Practice Address |
233 Ne 102nd Ave Portland OR 97220 |
| Mailing Address |
233 Ne 102nd Ave Portland OR 97220-4106 |
| Practice Telephone | 5035358325 |
| Practice Fax Number | 5035358399 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-08-26 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0202X |
Radiology Specialization: Diagnostic Radiology |
MD175728 | OR | Allopathic & Osteopathic Physicians |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962843417 | Priscilla Wallace | Social Worker | 2051 W Grand Blvd, Detroit, MI 48208-1105 | 2013-07-12 |
| Street Address |
233 NE 102ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97220 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568466548 | Kenneth R Curtin | Radiology | 233 Ne 102nd Ave, Portland, OR 97220-4106 | 2005-06-08 |
| 1740368695 | Joseph Jeffrey Haberman | Radiology | 233 Ne 102nd Ave, Portland, OR 97220 | 2006-11-01 |
| 1700984069 | Gerald Lloyd Warnock | Radiology | 233 Ne 102nd Ave, Portland, OR 97220-4106 | 2006-09-20 |
| 1043327547 | Christopher James Altenhofen | Radiology | 233 Ne 102nd Ave, Portland, OR 97220 | 2006-08-23 |
| 1962518662 | Warren Scott Tubbs | Radiology | 233 Ne 102nd Ave, Portland, OR 97220-4106 | 2006-08-22 |
| 1245346758 | Daniel Robert Kocarnik | Radiology | 233 Ne 102nd Ave, Portland, OR 97220 | 2006-08-21 |
| 1396858593 | Ryan Lee Taylor | Radiology | 233 Ne 102nd Ave, Portland, OR 97220 | 2006-08-15 |
| 1467565671 | Jennifer Purdy Mayberry | Radiology | 233 Ne 102nd Ave, Portland, OR 97220 | 2006-08-15 |
| 1790790293 | James Michael Pearson | Radiology | 233 Ne 102nd Ave, Portland, OR 97220-4106 | 2006-07-31 |
| 1336188358 | Michael E Stoll | Radiology | 233 Ne 102nd Ave, Portland, OR 97220-4106 | 2006-06-05 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316569254 | Debra Shamblin | Behavioral Analyst | 150 Ne 100th Ave, Portland, OR 97220 | 2020-05-14 |
| 1336780618 | Joan Lambert | Technician | 2802 Ne 108th Avenue, Portland, OR 97220 | 2019-10-08 |
| 1750933917 | Multnomah County | Clinic/Center | 11540 Ne Inverness Dr., Inverness Jail, Portland, OR 97220 | 2019-07-09 |
| 1194223107 | Landmark Connect of Oregon PC | General Practice | 5933 Ne Win Sivers Dr Ste 310, Portland, OR 97220 | 2018-01-24 |
| 1487178711 | Andrew Shonk | Massage Therapist | 163 Ne 102nd Ave Blid V, Portland, OR 97220 | 2017-07-28 |
| 1548781693 | Greater New Hope Family Services | Lodging | 11868 Ne Sandy Blvd, Portland, OR 97220 | 2017-06-29 |
| 1245771740 | Maria Teresa Banez Salcedo | Registered Nurse | 10300 Ne Hancock Street, Portland, OR 97220 | 2017-03-16 |
| 1568901858 | Christopher Gabriel Lyons | Adult Companion | 1343 Ne 118 Ave. Apt5, Portland, OR 97220 | 2017-02-20 |
| 1962945956 | Linda Ann Oldenburg | Registered Nurse | 9515 Ne Skidmore Avenue, Portland, OR 97220 | 2016-11-23 |
| 1326493446 | Trent D. Wilson | Massage Therapist | 8401 Ne Halsey St., Suite 101, Portland, OR 97220 | 2016-04-26 |
| Find all providers in zip 97220 | ||||
| Taxonomy Code | 2085R0202X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Diagnostic Radiology |
| A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1528413754 | Bay Area Radiology, PC | Radiology | 2823 Ne 55th Ave, Portland, OR 97213-3439 | 2016-04-25 |
| 1790171585 | Dianna Howard | Radiology | 3181 Sw Sam Jackson Rd, Portland, OR 97239-3011 | 2015-04-08 |
| 1245674506 | Jaryd Yee | Radiology | Ohsu Radiology Department, 3181 Sw Sam Jackson Park Rd., Portland, OR 97239-3011 | 2013-04-17 |
| 1700175874 | Ramsey Al-hakim | Radiology | 3181 Sw Sam Jackson Park Rd # L605, Portland, OR 97239-3011 | 2011-03-29 |
| 1386961712 | Yama Kharoti | Radiology | 2801 N Gantenbein Ave Ste 4239, Portland, OR 97227-1623 | 2010-04-25 |
| 1639313273 | David Pettersson | Radiology | Ohsu, 3181 Sw Sam Jackson Park Road, Portland, OR 97239 | 2009-04-27 |
| 1629276191 | Joe Mun-jung Chan | Radiology | 3181 Sw Sam Jackson Park Rd # L-340, Portland, OR 97239-3011 | 2007-07-06 |
| 1194846345 | Jay H Donohoo | Radiology | 01641 Sw Comus St, Portland, OR 97219-7858 | 2007-04-03 |
| 1851458046 | Summit Radiology Inc | Radiology | 1243 Sw Texas St, Portland, OR 97219-2046 | 2007-01-03 |
| 1376600064 | Jeffrey Terrance Hal | Radiology | 1926 W Burnside St, Unit 1604, Portland, OR 97209-2066 | 2007-01-02 |
| Find all providers in PORTLAND | ||||
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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.