| Gerald Adrian Wallace, CRNA | |
|
1253 Nw Canal Blvd, Redmond, OR 97756-1334 | |
| (541) 584-8131 | |
| Not Available |
| Full Name | Gerald Adrian Wallace |
|---|---|
| Gender | Male |
| Speciality | Nurse Anesthetist, Certified Registered |
| Location | 1253 Nw Canal Blvd, Redmond, Oregon |
| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1265478416 | NPI | - | NPPES |
| 029121 | Medicaid | OR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 163W00000X | Registered Nurse | (Oregon) | Primary |
| 367500000X | Nurse Anesthetist, Certified Registered | (Oregon) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Gerald Adrian Wallace, CRNA Po Box 4008, Portland, OR 97208-4008 Ph: (503) 372-2740 | Gerald Adrian Wallace, CRNA 1253 Nw Canal Blvd, Redmond, OR 97756-1334 Ph: (541) 584-8131 |
John Michael Unruh, CRNA Nurse Anesthetist - CR Medicare: Not Enrolled in Medicare Practice Location: 1253 Nw Canal Blvd, Redmond, OR 97756 Phone: 541-548-8131 Fax: 541-516-3877 | |
Jeremy Thomas Johnson, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1253 Nw Canal Blvd, Redmond, OR 97756 Phone: 541-548-8131 | |
Rachel Lynne Mitzel, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1253 Nw Canal Blvd, Redmond, OR 97756 Phone: 541-548-8131 Fax: 541-706-3765 | |
Christopher A Green, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1253 Nw Canal Blvd, Redmond, OR 97756 Phone: 541-548-8131 Fax: 541-516-3877 | |
Olivia Boots, CRNA Nurse Anesthetist - CR Medicare: Accepting Medicare Assignments Practice Location: 1253 Nw Canal Blvd, Redmond, OR 97756 Phone: 541-548-8131 |