Jared L. Wallace, PA-C
Physician Assistant · Kenai, AK
UnclaimedPA-CNPI 1063746667
- Primary taxonomy
- 363A00000X
- Enumerated
- 2009-09-29
- Practice location
- Kenai, AK
- Last NPPES update
- 2023-03-07
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.