Individual
JEFFREY ALLEN WALLHOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
19200 N KELSEY ST, MONROE, WA 98272-1431
(360) 794-7994
Mailing address
PO BOX 3360, PORTLAND, OR 97208-3360
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
53508
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1366676330
—
MN
Enumeration date
05/06/2009
Last updated
01/10/2014
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