Individual provider · Type 1 NPI
Khalil Rashaun Wallace
Student in an Organized Health Care Education/Training Program · Fairchild Afb, WA
NPI number
1528516580
Active
Practice location
7275 Nebraska Ave
Fairchild Afb, WA 99011-3001
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Athletic Trainer | 2255A2300X | None listed |
| Student in an Organized Health Care Education/Training Program Primary | 390200000X | None listed |
Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
About NPI 1528516580
Khalil Rashaun Wallace's National Provider Identifier is 1528516580, issued on Sep 19, 2016. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Fairchild Afb, WA. The record was last updated on Sep 19, 2016.