Individual
JORDAN SCOTT WALLACE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
9801 FRONTIER AVE SE, SNOQUALMIE, WA 98065-5200
(425) 831-2300
Mailing address
9801 FRONTIER AVE SE, SNOQUALMIE, WA 98065-5200
(425) 831-2300
(425) 396-7694
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD61570069
WA
Other
Enumeration date
03/22/2020
Last updated
10/15/2025
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