Individual provider · Type 1 NPI

Theodore William Wallace, PA-C

Physician Assistant · Tacoma, WA

NPI number 1609931393 Active

Practice location

Madigan Army Medical Ctr, 9040A Fitzsimmons Dr
Tacoma, WA 98431-0001

Call (253) 968-5161 Map

Mailing address

6317 63rd St W
University Place, WA 98467-4945

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant Primary 363A00000XPA100003556 (WA)

Physician Assistant: A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, orde…

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About NPI 1609931393

Theodore William Wallace, PA-C's National Provider Identifier is 1609931393, issued on Dec 25, 2006. The primary taxonomy on file is Physician Assistant (363A00000X), and the practice location is in Tacoma, WA. The record was last updated on Jul 8, 2007.