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.
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 |
Claim Control Number (CCN) | Legal Business Name |
---|---|
380075 | PROVIDENCE MEDFORD MEDICAL CENTER |
Address | Phone | Organization |
---|---|---|
1111 Crater Lake Ave, Medford, OR 97504-6241 | 5417326274 | PROVIDENCE HEALTH AND SERVICES - OREGON |
Organization Legal Name | PROVIDENCE HEALTH AND SERVICES - OREGON |
Physicians | 101 |
Name | Specialty | Organization | Address |
---|---|---|---|
Karina M Squire | Nurse Practitioner | Providence Health and Services - Oregon | 171 S Hwy 101, Warrenton, OR 97146-9314 |
Randy L Sasich | Pulmonary Disease | Providence Health and Services - Oregon | 501 Villa Rd, Newberg, OR 97132-1832 |
Shelley A Denison | Nurse Practitioner | Providence Health and Services - Oregon | 10140 Sw Park Way, Portland, OR 97225-5008 |
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 |
Elke P Lowenkopf | Hospice/palliative Care | Providence Health and Services - Oregon | 1500 Division St, Rm 1005, Oregon City, OR 97045-1527 |
Elise Newman | Hospice/palliative Care | Providence Health and Services - Oregon | 4805 Ne Glisan St, Portland, OR 97213-2933 |
Talya L Freudmann | Nurse Practitioner | Providence Health and Services - Oregon | 10140 Sw Park Way, Portland, OR 97225-5008 |
Street Address |
1111 CRATER LAKE AVE |
City | MEDFORD |
State | OR |
Zip | 97504-6241 |
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 |
Find all physicians in the same address |
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 |
Find all physicians in zip 97504 |
City | MEDFORD |
Zip Code | 97504 |
Specialty | NURSE PRACTITIONER |
City + Specialty | MEDFORD + NURSE PRACTITIONER |
Please comment or provide details below to improve the information on Cynthia L Wallace.
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.