LAURA FRENCH WALLACE (NPI# 1033597505) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1033597505 |
| Entity Type | Individual |
| Full Name | LAURA FRENCH WALLACE |
| Other Name | LAURA WALLACE |
| Practice Address |
1015 Nw 22nd Ave Portland OR 97210 |
| Mailing Address |
Po Box 4037 Portland OR 97208-4037 |
| Practice Telephone | 5034138090 |
| Practice Fax Number | 5034137490 |
| Mailing Telephone | 5034134048 |
| Mailing Fax Number | 5034132910 |
| Enumeration Date | 2015-05-15 |
| Last Update Date | 2020-07-20 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363A00000X | Physician Assistant | PA179418 | OR | Physician Assistants & Advanced Practice Nursing Providers |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 3181 Sw Sam Jackson Park Rd, Gh219, Portland, OR 972393011 | 8586031815 |
| Street Address |
1015 NW 22ND AVE |
| City | PORTLAND |
| State | OR |
| Zip Code | 97210 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467449629 | Chen-wen Christopher Heh | Psychiatry & Neurology | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2005-10-03 |
| 1023620770 | Jenelle Lynn Stinson | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2020-08-22 |
| 1821618935 | Jena Jobin | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2020-04-17 |
| 1164041810 | Danielle Amelie Parker | Occupational Therapist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2020-04-13 |
| 1659910362 | Ellen Lee | Nurse Anesthetist, Certified Registered | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-12-27 |
| 1487291787 | Nicholai Leon Mathewson | Nurse Anesthetist, Certified Registered | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-12-05 |
| 1528603438 | Lap Huy Nguyen | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-11-14 |
| 1649814617 | Ethan Andrew Blashford | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-11-03 |
| 1770127854 | Meri Leah Grotzinger | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-11-01 |
| 1467095307 | Dennis Thompson | Pharmacist | 1015 Nw 22nd Ave, Portland, OR 97210-3025 | 2019-10-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679109086 | Joseph Francolino | Massage Therapist | 2174 Nw Davis Street, Apartment 105, Portland, OR 97210 | 2020-03-17 |
| 1215574058 | Northwest Dbt LLC | Psychologist | 2230 Nw Pettygrove St., Suite 130, Portland, OR 97210 | 2019-11-27 |
| 1649769480 | Dipesh Patel | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Ave. Legacy Clinic Good Samaritan, Portland, OR 97210 | 2018-05-08 |
| 1760987234 | Meghan Teague | Student in an Organized Health Care Education/Training Program | Legacy Good Samaritan Medical Center- Gme, 1015 Nw 22nd Ave, Portland, OR 97210 | 2018-03-27 |
| 1205349172 | Paul M Storm | Acupuncturist | 1708 Nw 25th Ave. Apt. #6, Portland, OR 97210 | 2017-11-14 |
| 1740703750 | Audra K Berning | Massage Therapist | 2122 Nw Quimby, Root Whole Body, Portland, OR 97210 | 2017-07-21 |
| 1720539810 | Anna-marie Elizabeth Wood | Audiologist | 2222 Nw Lovejoy St Ste 662, Portland, OR 97210 | 2016-10-24 |
| 1659829836 | H&s Pearl, LLC | Massage Therapist | 25 Nw 23rd Pl, Suite 7, Portland, OR 97210 | 2016-09-15 |
| 1255785796 | Cortez Natural Medicine, Inc. | Acupuncturist | 2230 Nw Pettygove Street, Unit 130, Portland, OR 97210 | 2016-04-21 |
| 1932563616 | Vincent Chen | Student in an Organized Health Care Education/Training Program | 1200 Nw 23rd Avenue, Legacy Clinic Good Samaritan, Portland, OR 97210 | 2016-04-08 |
| Find all providers in zip 97210 | ||||
| Taxonomy Code | 363A00000X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427676493 | Lindsey Louise Peterson | Physician Assistant | 3505 N Williams Ave, Portland, OR 97227-1437 | 2020-07-07 |
| 1518584036 | Abigail Nichole Dumont | Physician Assistant | 6064 Sw 30th Ave, Portland, OR 97239-1018 | 2020-06-30 |
| 1336769637 | Molly Tanguay | Physician Assistant | 23 Bramhall St, Portland, ME 04102-3121 | 2020-04-16 |
| 1063040525 | Jessica Nursick | Physician Assistant | 26 Sand Hill Rd, Portland, CT 06480-1737 | 2020-03-31 |
| 1689217630 | Evan Eisher | Physician Assistant | 3809 Se Stephens St, Portland, OR 97214-5248 | 2019-10-22 |
| 1508407941 | Amie Bates | Physician Assistant | 1040 Nw 22nd Ave # Ll030, Portland, OR 97210-3057 | 2019-10-07 |
| 1558923326 | Mackenzie Graye Mcmillin | Physician Assistant | 1601 Congress St Ste 1, Portland, ME 04102-2145 | 2019-07-02 |
| 1447812268 | Maksim Yefimov | Physician Assistant | 2800 N Vancouver Ave Ste 130, Portland, OR 97227 | 2019-07-01 |
| 1942794839 | Michael Peterson | Physician Assistant | 3181 Sw Sam Jackson Park Rd # P31, Portland, OR 97239-3098 | 2018-06-14 |
| 1306383930 | Rachel Lynn Witowski | Physician Assistant | 2124 Nw Hoyt St, Portland, OR 97210-3215 | 2017-01-20 |
| Find all providers in PORTLAND | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.