Individual
MRS. DANHUA K WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
101 N. MAIN STREET, COUPEVILLE, WA 98239
(360) 678-7656
Mailing address
101 N. MAIN STREET, COUPEVILLE, WA 98239
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
AP30006550
WA
363L00000X
Nurse Practitioner
H138175
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1134320401
—
IA
01
—
P01375308
RR MEDICARE
IA
Enumeration date
05/31/2007
Last updated
12/09/2014
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