Individual
DANIEL WALLACH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2621 NE 134TH ST STE 140, VANCOUVER, WA 98686-3036
(360) 504-0122
(360) 839-1354
Mailing address
823 SE 36TH ST, BATTLE GROUND, WA 98604-3197
(541) 373-7880
Taxonomy
Speciality
Code
Description
License number
State
225200000X
Physical Therapy Assistant
Primary
9921
OR
225200000X
Physical Therapy Assistant
—
—
Other
Enumeration date
08/28/2016
Last updated
01/20/2025
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