Individual
ROBIN L WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3901 HOYT AVE, EVERETT, WA 98201-4918
(425) 339-5413
(425) 339-4213
Mailing address
3901 HOYT AVE, EVERETT, WA 98201-4918
(425) 339-5413
(425) 339-4213
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
60190019
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
60190019
AP STATE LICENSE
WA
Enumeration date
10/15/2010
Last updated
10/15/2010
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