Individual provider · Type 1 NPI

Dereka Wallace, RN

Emergency Registered Nurse · Puyallup, WA

NPI number 1346040649 Active

Practice location

401 15th Ave SE
Puyallup, WA 98372-3715

Specialties and licenses

TaxonomyCodeLicense
Emergency Registered Nurse Primary 163WE0003X61519413 (WA)

Emergency Registered Nurse: Definition to come...

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About NPI 1346040649

Dereka Wallace, RN's National Provider Identifier is 1346040649, issued on Mar 17, 2025. The primary taxonomy on file is Emergency Registered Nurse (163WE0003X), and the practice location is in Puyallup, WA. The record was last updated on Mar 17, 2025.