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Jonathan Wesley Wallace, MD
Family Medicine Physician in Vancouver, Washington
NPI 1487342119

Jonathan Wesley Wallace is a Family Medicine Physician based in Vancouver, WA. Jonathan Wesley Wallace practices in Vancouver, WA and has the professional credentials of MD. The NPI Number for Jonathan Wesley Wallace is 1487342119 and holds a License No. (Washington).

The current practice location address for Jonathan Wesley Wallace is 100 E 33Rd St Ste 100, Vancouver, WA and can be reached out via phone at 360-514-7556.

Location: 100 E 33Rd St Ste 100, Vancouver, WA, 98663-2776
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1487342119
Provider Name
Jonathan Wesley Wallace
Credential
MD
Provider Entity Type
Individual
Gender
Male
Address
100 E 33Rd St Ste 100, Vancouver, WA, 98663-2776
Phone Number
360-514-7556
Fax Number
Provider Enumeration Date
05/01/2023
Last Update Date
03/10/2024
institution
Provider Business Practice Location Address Details
Address
100 E 33Rd St Ste 100
City
Vancouver
State
Washington
Zip
98663-2776
Phone Number
360-514-7556
Fax Number
person
Provider Business Mailing Address Details
Address
100 E 33Rd St Ste 100
City
Vancouver
State
Washington
Zip
98663-2776
Phone Number
360-514-7556
Fax Number
person
Provider's Taxonomy Details 1
Type
Allopathic & Osteopathic Physicians
Classification
Family Medicine
Speciality
-
Taxonomy
207Q00000X
License No.
ML61440736 (Washington)
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
person
Provider's Taxonomy Details 2
Type
Student, Health Care
Classification
Student in an Organized Health Care Education/Training Program
Speciality
-
Taxonomy
390200000X
License No.
()
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
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