person
Joanne M Wallis, PNP
Primary Care Nurse Practitioner in Vancouver, Washington
NPI 1932370756

Joanne M Wallis is a Primary Care Nurse Practitioner based in Portland, WA and is specialized in Primary Care. Joanne M Wallis practices in Vancouver, WA and has the professional credentials of PNP. The NPI Number for Joanne M Wallis is 1932370756 and holds a License No. 091000332N2-PNP-PP (Washington).

The current practice location address for Joanne M Wallis is 19005 Se 34Th St, Vancouver, WA and can be reached out via phone at 360-726-6724 and via fax at 360-726-6718. You can also correspond with Joanne M Wallis through the mailing address at 426 SW STARK ST FL 9, PORTLAND, OR - 97204-2347 (mailing address contact number: 503-988-5958).

Location: 19005 Se 34Th St, Vancouver, WA, 97204-2347
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Provider Profile Details
NPI Number
1932370756
Provider Name
Joanne M Wallis
Credential
PNP
Provider Entity Type
Individual
Gender
Female
Address
19005 Se 34Th St, Vancouver, WA, 97204-2347
Phone Number
360-726-6724
Fax Number
360-726-6718
Provider Enumeration Date
03/19/2008
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
022959 05 OR
22959 05 OR
institution
Provider Business Practice Location Address Details
Address
19005 Se 34Th St
City
State
Zip
98683-1450
Phone Number
360-726-6724
Fax Number
360-726-6718
person
Provider Business Mailing Address Details
Address
426 Sw Stark St Fl 9
City
State
Zip
97204-2347
Phone Number
503-988-5958
Fax Number
503-988-4093
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Pediatrics
Taxonomy
License No.
AP30006123 (Washington)
Definition
Definition to come...
person
Provider's Taxonomy Details 2
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Primary Care
Taxonomy
License No.
091000332N2-PNP-PP (Oregon)
Definition
Definition to come...
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