Search › Oregon › 363A00000X
Laura French Wallace
NPI 1033597505 · on the registry since 2015 · sole proprietor
Practice
- Address
- 1015 Nw 22nd Ave
Portland, OR 97210 - Phone
- (503) 413-8090
- Fax
- (503) 413-7490
- Organisation at this address
- Team Health
Mark A Crislip
Victor N Takla Md Llc
Criag W. Calhoun Md Pc
Diagnostic Imaging, Nw PcInferred from a shared address, not stated in the registry. - Clinicians at this address
- 206
Additional practice sites
- 3181 Sw Sam Jackson Park Rd, Portland, OR
Registry record
- Primary taxonomy
- 363A00000X
363A00000X
- Also registered as
- 390200000X
- Licence states on file
- OR
From the registry's licence fields, which are often incomplete.
- Sex
- Female
- Record last updated
- 2020-07-20
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Oregon