Carol Ann Wallace, MD

NPI #1639272412 in Clackamas, Oregon

Provider Information

NPI Number
1639272412
Entity Type
Individual
Name
Carol Ann Wallace, MD
Gender
Not Specified
Sole Proprietor
Yes
Primary Specialty
Health Maintenance Organization
Credential
MD
Enumeration Date
Sep 6, 2006
Last Updated
Jul 8, 2007

Practice Location

Address
10180 SE SUNNYSIDE RD
State
Oregon
ZIP Code
97015-8970
Phone
(503) 652-2880

Specialties & Taxonomy Codes

Specialty
Health Maintenance Organization

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