Kristina M. Wallace, PA-C
Physician Assistant · Grants Pass, OR
UnclaimedPA-CNPI 1417326984
- Primary taxonomy
- 363A00000X
- Enumerated
- 2015-09-15
- Practice location
- Grants Pass, OR
- Last NPPES update
- 2020-06-08
State licenses
- OR · Physician assistant · NPPES self-reportedListed on NPI record
“Listed on NPI record” means the provider reported this license to NPPES; other statuses come from the state board’s public records as of the last import. License numbers are not shown.
Source: CMS National Plan & Provider Enumeration System (NPPES) and state licensing boards. ScrubHub shows name, credential, taxonomy, practice city/state and license status only.