Matthew French Wallace, PA-C

NPI #1386091015 in Tillamook, Oregon

Provider Information

NPI Number: 1386091015
Entity Type: Individual
Name: Matthew French Wallace, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: May 23, 2016
Last Updated: Jul 27, 2021

Practice Location

Address: 1100 3RD ST
City: Tillamook
State: Oregon
ZIP Code: 97141-3402
Phone: (503) 842-5546

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary
Student in an Organized Health Care Education/Training Program	390200000X

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