Gibbons, Wallace
Gibbons, Wallace is an individual health care provider with primary practice located at 820 N Chelan Ave , Wenatchee WA 98801-2028. He recently has only one registered license in Allopathic & Osteopathic Physicians / Urology, which is considered as his primary health care specialty. Gibbons, Wallace can be contacted via phone (509) 663-8711.Contact Information
Primary practice address
820 N Chelan Ave
Wenatchee WA 98801-2028
Phone: (509) 663-8711
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Urology | 208800000X | MD00024544 | Washington |
Profile Details
| NPI number | 1932134244 |
|---|---|
| LBN Legal business name | Gibbons, Wallace |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jul 12th, 2006 |
| Last updated | Jun 21st, 2022 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1932134244 | NPPES |
| Washington | Other | P01256576 | RR MEDICARE |
| Washington | MEDICAID | 1932134244 | RR MEDICARE |
| Washington | Other | 31238 | RR MEDICARE |
| Washington | Other | 315977 | RR MEDICARE |
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