Dr James C Wallace, MD | |
834 Sheridan St, Port Townsend, WA 98368-2443 | |
(136) 038-5220 | |
Not Available |
Full Name | Dr James C Wallace |
---|---|
Gender | Male |
Speciality | Emergency Medicine |
Location | 834 Sheridan St, Port Townsend, Washington |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1801864327 | NPI | - | NPPES |
8128357 | Medicaid | WA | |
1126WA | Other | REGENCE BLUE SHIELD RIDER | |
820000117 | Other | RAILROAD MEDICARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207P00000X | Emergency Medicine | MD00028714 (Washington) | Primary |
Entity Name | Jefferson County Public Hospital District No 2 |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356492953 PECOS PAC ID: 4789593708 Enrollment ID: O20031111000542 |
Entity Name | Prosser Public Hospital District Of Benton County |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1306897681 PECOS PAC ID: 6709787872 Enrollment ID: O20040120000974 |
Entity Name | Okanogan Douglas County Hospital Dist 1 |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1205942257 PECOS PAC ID: 7810882792 Enrollment ID: O20040219000122 |
Entity Name | Sunnyside Emergency Group A Professional Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1033529367 PECOS PAC ID: 0941424451 Enrollment ID: O20140623002600 |
Mailing Address | Practice Location Address |
---|---|
Dr James C Wallace, MD 834 Sheridan St, Port Townsend, WA 98368-2443 Ph: (360) 385-2200 | Dr James C Wallace, MD 834 Sheridan St, Port Townsend, WA 98368-2443 Ph: (136) 038-5220 |
Elizabeth Anne Yeater, ARNP Emergency Medicine Medicare: Medicare Enrolled Practice Location: 834 Sheridan St, Port Townsend, WA 98368 Phone: 360-385-2200 | |
Dr. Ronald W. Irick Ii, D.O. Emergency Medicine Medicare: Medicare Enrolled Practice Location: 834 Sheridan St, Port Townsend, WA 98368 Phone: 360-385-2200 | |
Olivia Stephanie Haesloop, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 834 Sheridan St, Port Townsend, WA 98368 Phone: 360-385-2200 | |
Douglas T Nelsen, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 834 Sheridan St, Port Townsend, WA 98368 Phone: 360-385-1252 Fax: 360-335-1252 | |
Dr. Christopher James Davis, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 834 Sheridan St, Port Townsend, WA 98368 Phone: 360-385-2200 | |
Steven Hillman, MD Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 2500 W Sims Way, Suite 1, Port Townsend, WA 98368 Phone: 360-344-3663 Fax: 360-344-3664 |