Organization
STEPHEN J WALLACE MD PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEPHEN J WALLACE MD (MD)
(270) 556-0604
Entity
Organization
Contact information
Practice address
4103 MERCANTILE DR, LAKE OSWEGO, OR 97035-2556
(503) 850-9940
(503) 850-6709
Mailing address
4103 MERCANTILE DR, LAKE OSWEGO, OR 97035-2556
(503) 850-9940
(503) 850-6709
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
—
—
207XX0801X
Orthopaedic Trauma Physician
Primary
—
—
Other
Enumeration date
10/24/2021
Last updated
01/08/2026
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