Cynthia L Wallace
PROVIDENCE HEALTH AND SERVICES - OREGON


Address: 1111 Crater Lake Ave, Medford, OR 97504-6241
Phone: 5417326274

Cynthia L Wallace (NPI# 1811393648, PAC ID# 7911219035) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is NURSE PRACTITIONER.

Physician Overview

Nation Provider ID (NPI) 1811393648
PAC ID by PECOS 7911219035
Professional Enrollment ID I20150702000790
Full Name Cynthia L Wallace
Organization Legal Name PROVIDENCE HEALTH AND SERVICES - OREGON
Address 1111 Crater Lake Ave
Medford
OR 97504-6241
Phone Number 5417326274
Gender F
Graduation Year 2014
Primary Specialty NURSE PRACTITIONER
Group Practice PAC ID 6305755000
Number of Group Practice Members 18
Accepts Medicare Assignment Y

Claims Based Hospital Affiliation

Claim Control Number (CCN) Legal Business Name
380075 PROVIDENCE MEDFORD MEDICAL CENTER

Other Locations

Address Phone Organization
1111 Crater Lake Ave, Medford, OR 97504-6241 5417326274 PROVIDENCE HEALTH AND SERVICES - OREGON

Organization Information

Organization Legal Name PROVIDENCE HEALTH AND SERVICES - OREGON
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Allan R Alexander Family Practice Providence Health and Services - Oregon 2100 Ne 139th St, Vancouver, WA 98686-2300
Deborah S Dorst Nurse Practitioner Providence Health and Services - Oregon 6410 Ne Halsey St, Portland, OR 97213-4759
Sharon F Lissman Hospice/palliative Care Providence Health and Services - Oregon 4805 Ne Glisan St, Portland, OR 97213-2933
Shoshawna Rainwater Clinical Social Worker Providence Health and Services - Oregon 10140 Sw Park Way, Portland, OR 97225-5008
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Office Location

Street Address 1111 CRATER LAKE AVE
City MEDFORD
State OR
Zip 97504-6241

Physicians in the same location

Name Specialty Organization Address
Stephen E Christensen Hospitalist Providence Health and Services Oregon 1111 Crater Lake Ave, Medford, OR 97504-6241
Brett M Williams Nurse Practitioner Providence Health and Services Oregon 1111 Crater Lake Ave, Medford, OR 97504-6241
Emilia Arden Cardiovascular Disease (cardiology) Providence Health and Services Oregon 1111 Crater Lake Ave, Medford, OR 97504-6241
Ryan Garrett Emergency Medicine Providence Health and Services Oregon 1111 Crater Lake Ave, Medford, OR 97504-6241
James C Cook Jr. Cardiovascular Disease (cardiology) Providence Health and Services Oregon 1111 Crater Lake Ave, Medford, OR 97504-6241
Timothy Hutchings Urology Providence Health and Services Oregon 1111 Crater Lake Ave, Medford, OR 97504-6241
David E Harris Physical Medicine and Rehabilitation Providence Health and Services Oregon 1111 Crater Lake Ave, Medford, OR 97504-6241
Carla N Overstreet Nurse Practitioner Providence Health and Services Oregon 1111 Crater Lake Ave, Medford, OR 97504-6241
Eric T Mullen Radiation Oncology Radiation Oncology Group Consultants P C 1111 Crater Lake Ave, Medford, OR 97504-6241
Hannah I Young Internal Medicine Providence Health and Services Oregon 1111 Crater Lake Ave, Medford, OR 97504-6241
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Physicians in the same zip code

Name Specialty Organization Address
Kimberly Anne Zaslow Family Medicine Providence Health and Services Oregon 70 Bower Dr, Medford, OR 97504
Benjamin Robert Oldson Family Medicine Providence Health and Services Oregon 70 Bower Dr, Medford, OR 97504
Shirley A Malcolm Osteopathic Manipulative Medicine Providence Health and Services Oregon 70 Bower Dr, Medford, OR 97504
Denise M Viss Nurse Practitioner Providence Health and Services Oregon 70 Bower Dr, Medford, OR 97504
Carissa D Scalf Psychologist, Clinical Providence Health and Services Oregon 70 Bower Dr, Medford, OR 97504
Wesley T Ramoso Family Medicine Providence Health and Services Oregon 70 Bower Dr, Medford, OR 97504
Uzomechine Thabiso Chiedozi Family Medicine Providence Health and Services Oregon 70 Bower Dr, Medford, OR 97504
Grant A Jolliffe Nurse Practitioner Providence Health and Services Oregon 70 Bower Dr, Medford, OR 97504
Travis Adam Day Nurse Practitioner Providence Health and Services Oregon 70 Bower Dr, Medford, OR 97504
Jasmin Williams Clinical Social Worker Options for Southern Oregon 1700 E Barnett Rd, Medford, OR 97504-0052
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Competitor

Search similar physicians

City MEDFORD
Zip Code 97504
Specialty NURSE PRACTITIONER
City + Specialty MEDFORD + NURSE PRACTITIONER

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS)
Jurisdiction Medicare

This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.

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