Wallace, Ryan Myles

Wallace, Ryan Myles is an individual health care provider with primary practice located at 3760 Piper St Ste 1108 , Anchorage AK 99508-4683. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Psychiatry, Allopathic & Osteopathic Physicians / Neurology. Allopathic & Osteopathic Physicians / Psychiatry is his primary health care specialty. Wallace, Ryan Myles can be contacted via phone (907) 212-6900.

Contact Information

Primary practice address
3760 Piper St Ste 1108 Anchorage AK 99508-4683
Phone: (907) 212-6900
Fax: (907) 212-6936
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 158491 Alaska
Allopathic & Osteopathic Physicians / Psychiatry 2084P0800X 55490 Connecticut
Allopathic & Osteopathic Physicians / Neurology 2084N0400X 55490 Connecticut

Profile Details

NPI number 1548695075
LBN Legal business name Wallace, Ryan Myles
Credentials
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 3rd, 2013
Last updated Dec 3rd, 2025 - about last year

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548695075 NPPES
Alaska MEDICAID 1709157
Alaska MEDICAID 008056168
Alaska MEDICAID 500000315
Alaska MEDICAID 008076123
Alaska MEDICAID 004082286
Alaska MEDICAID 008022626

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