Individual
CHRIS C WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LMP
Contact information
Practice address
9042 6TH AVE NW, SEATTLE, WA 98117-2117
(206) 719-7622
Mailing address
9042 6TH AVE NW, SEATTLE, WA 98117-2117
(206) 719-7622
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Enumeration date
11/20/2006
Last updated
07/08/2007
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