Individual
DR. JOHN G WALLACE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
17515 N PARK PL N, SHORELINE, WA 98133-4803
(206) 533-2158
(206) 533-2158
Mailing address
17515 N PARK PL N, SHORELINE, WA 98133-4803
(206) 533-2158
(206) 533-2158
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
00008964
WA
Other
Enumeration date
03/05/2007
Last updated
07/08/2007
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