Individual
WAYNE J WALLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2339 FEDERAL AVE E, SEATTLE, WA 98102-4031
(206) 724-4401
Mailing address
2339 FEDERAL AVE E, SEATTLE, WA 98102-4031
(206) 724-4401
Taxonomy
Speciality
Code
Description
License number
State
207RR0500X
Rheumatology Physician
Primary
MD00019116
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8574600
—
WA
Enumeration date
05/01/2007
Last updated
09/03/2015
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