Kristina Marie Wallace, PA-C

NPI #1417326984 in Grants Pass, Oregon

Provider Information

NPI Number: 1417326984
Entity Type: Individual
Name: Kristina Marie Wallace, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Sep 15, 2015
Last Updated: Jun 8, 2020

Practice Location

Address: 537 UNION AVE
Address 2: SECOND FLOOR
City: Grants Pass
State: Oregon
ZIP Code: 97527-5543
Phone: (541) 479-6777

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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