MRS. CYNTHIA WALLACE


Address: 1111 Crater Lake Ave, Medford, OR 97504-6241
Phone: 5417325250

MRS. CYNTHIA WALLACE (NPI# 1811393648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1811393648
Entity Type Individual
Full Name MRS. CYNTHIA WALLACE
Credential AGPCNP
Practice Address 1111 Crater Lake Ave
Medford
OR 97504-6241
Mailing Address Po Box 3308
Portland
OR 97208-3308
Practice Telephone 5417325250
Practice Fax Number 5417325251
Mailing Telephone 5417325250
Mailing Fax Number 5417325152
Enumeration Date 2014-11-05
Last Update Date 2020-09-30
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LG0600X Nurse Practitioner
Specialization: Gerontology
201500016NP-PP OR Physician Assistants & Advanced Practice Nursing Providers

Other Providers CYNTHIA WALLACE

NPI Name Taxonomy Address Enumeration
1427677848 Cynthia Wallace Home Health Aide 4513 Minaret Way, North Las Vegas, NV 89031-4319 2020-04-15
1215290051 Cynthia Wallace Home Health Aide 3538 Stanton Rd Se, Washington, DC 20020-2288 2012-06-18
1093075913 Cynthia Wallace Social Worker 19 E Birch St Ste 103, Walla Walla, WA 99362-3084 2012-05-24
1841509569 Cynthia Jane Wallace Registered Nurse 310 Eastwood Ave, Delaware, OH 43015-1004 2010-09-29
1740241835 Cynthia Calbert Wallace Obstetrics & Gynecology 2000 Se Blue Pkwy, Lees Summit, MO 64063-1041 2006-03-29
1386615540 Cynthia L Wallace Family Medicine 4777 Andrew Jackson Pkwy, Suite 101, Hermitage, TN 37076-1356 2006-01-27
1528573524 Cynthia Wallace Counselor 914 Baumann Dr, Grand Island, NE 68803-4401 2017-12-12
1619487410 Cynthia Marie Wallace Counselor 5648 Friendship Ave, Pittsburgh, PA 15206-3610 2017-10-05
1942608088 Cynthia Wallace Social Worker 832 Mckinley Ave Nw, Canton, OH 44703-2463 2014-12-05
1730596875 Cynthia Catherine Wallace Dermatology 5530 Wisconsin Ave, 820, Chevy Chase, MD 20815-4404 2014-07-21

Office Location

Street Address 1111 CRATER LAKE AVE
City MEDFORD
State OR
Zip Code 97504-6241

Providers in the same location

NPI Name Taxonomy Address Enumeration
1558361378 Craig S. Thalacker Emergency Medicine 1111 Crater Lake Ave, Medford, OR 97504-6241 2005-07-22
1447865464 Annabel M Walker Nurse Practitioner 1111 Crater Lake Ave, Medford, OR 97504-6241 2020-09-15
1386256519 Ryan Tierney Physical Therapist 1111 Crater Lake Ave, Medford, OR 97504-6241 2020-08-19
1992362867 Courtney Howarth Physical Therapy Assistant 1111 Crater Lake Ave, Medford, OR 97504-6241 2019-05-24
1811470107 Nicole Marie Choyce Dietitian, Registered 1111 Crater Lake Ave, Medford, OR 97504-6241 2018-09-12
1336621721 Tai Bailey Shelton Physical Therapist 1111 Crater Lake Ave, Medford, OR 97504-6241 2018-08-31
1932681533 Jacqueline Lucas-morris Occupational Therapist 1111 Crater Lake Ave, Medford, OR 97504-6241 2018-08-30
1477035236 Sarah Rae Hanley Occupational Therapist 1111 Crater Lake Ave, Medford, OR 97504-6241 2018-08-29
1306327242 Elizabeth Carlton Physical Therapist 1111 Crater Lake Ave, Medford, OR 97504-6241 2018-08-28
1851872428 Ida Marielke Funke Physical Therapist 1111 Crater Lake Ave, Medford, OR 97504-6241 2018-08-22
Find all providers in the same location

Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1225673833 Lydia D Sneed Behavioral Analyst 3707 Citation Way, Suite 102, Medford, OR 97504 2019-11-07
1114577368 Heather Ashley Fronek Nurse Practitioner 2825 E. Barnett Rd., Medford, OR 97504 2019-09-18
1255809109 Justin Blasdel Technician, Health Information 3250 Lone Pine Rd, Medford, OR 97504 2018-11-08
1396220133 Aimee K Michel Massage Therapist 3550 National Dr., Medford, OR 97504 2018-09-27
1437646908 Zola Dental Medford LLC Dentist 922 E Main, Medford, OR 97504 2018-04-19
1376068015 Megan Leggett Counselor 777 Murphy Road, Medford, OR 97504 2017-08-03
1023547536 Joshua Morgan Rice Dentist 1117 E Main St Ste 1, Medford, OR 97504 2017-06-08
1427580232 Paul James Dean Counselor 1175 Main St Ste 1c, Medford, OR 97504 2017-03-30
1811443542 Taya Adams Doula 1201 Progress Dr #90, Medford, OR 97504 2016-09-01
1174076228 Avalon Health Care - Hearthstone, LLC Skilled Nursing Facility 2091 E. Barnett Road, Medford, OR 97504 2016-07-25
Find all providers in zip 97504

Taxonomy Information

Taxonomy Code 363LG0600X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Gerontology

Taxonomy Definition

Definition to come...

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1417581315 Well Spring Health LLC Nurse Practitioner 835 Crater Lake Ave, Medford, OR 97504-6505 2020-02-28
1861926586 Dashia Hewitt Nurse Practitioner 825 Bennett Ave, Medford, OR 97504-6715 2017-04-19
1396143624 Laurie Young Nurse Practitioner 170 Governors Ave, Medford, MA 02155-1643 2014-12-19
1427181767 Landa Rhoda Cox Nurse Practitioner 1200 Mira Mar Ave, Medford, OR 97504-8546 2007-03-14
1376521369 Stacey Bryant Nurse Practitioner 170 Governors Ave, Hallmark Health System, Inc., Medford, MA 02155-1643 2006-01-09

Providers in the same taxonomy and state

NPI Name Taxonomy Address Enumeration
1558383430 Nancy A Erb Nurse Practitioner 16209 W Hoffeldt Ln, Suite B, Brookings, OR 97415-9470 2006-07-23
1124058789 Elizabeth Vonwellsheim Nurse Practitioner 382b South 58th Street, Springfield, OR 97478 2006-07-03
1568419091 Carolyn Dolores Concia Nurse Practitioner 2308 Nw Stimpson Ln, Portland, OR 97229-8562 2006-05-30
1821647173 Haley Grace Ruljancich Nurse Practitioner 4010 Aerial Way, Eugene, OR 97402-9757 2019-09-10
1043862550 Katherine Felicia Edstrom Nurse Practitioner 3181 Sw Sam Jackson Park Rd, Portland, OR 97239-3011 2019-07-15
1487216669 Carolyn D Concia Np Prof Corp Nurse Practitioner 2308 Nw Stimpson Ln, Portland, OR 97229-8562 2019-07-08
1811550866 Elisa Denise Garrett Nurse Practitioner 675 N 5th St, Lebanon, OR 97355-2875 2019-04-16
1255800850 Peter Woodring Nurse Practitioner 610 Hawthorne Ave Se Ste 110, Salem, OR 97301-5378 2018-11-13
1154809903 Molly Christine Davis Nurse Practitioner 4805 Ne Glisan St Ste 11n, Portland, OR 97213-2933 2018-08-03
1851841357 Marquis Companies I, Inc. Nurse Practitioner 4560 Se International Way, Suite 100, Milwaukie, OR 97222-4628 2016-10-07
Find all providers with the same taxonomy

Competitor

Search similar providers

City MEDFORD
Zip Code 97504

Improve Information

Please comment or provide details below to improve the information on MRS. CYNTHIA WALLACE.

Dataset Information

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.

Trending Searches