Individual
VARVARA WALLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
2300 I ST NW, WASHINGTON, DC 20052-0011
(202) 994-7644
Mailing address
15042 REYNOSA DR, RANCHO MURIETA, CA 95683-9143
(415) 596-0991
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
—
Other
Enumeration date
07/29/2021
Last updated
02/04/2022
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