# MATTHEW FRENCH WALLACE

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** No

## Provider details

- **NPI number:** 1386091015
- **Gender:** Man
- **Credential:** PA-C

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363A00000X | Physician Assistant | 60923310 | WA | — |
| 363A00000X | Physician Assistant | PA184421 | OR | Yes |
| 390200000X | Student in an Organized Health Care Education/Training Program | — | NULL | — |

## Other

- **Enumeration date:** 05/23/2016
- **Last updated:** 08/07/2026

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 60923310 | WA STATE LICENSE | WA |
| 01 | — | PA184421 | OR STATE LICENSE | OR |