Wallace, Stephen J

Wallace, Stephen J is an individual health care provider with primary practice located at 4103 Mercantile Dr , Lake Oswego OR 97035-2556. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Orthopaedic Surgery, Allopathic & Osteopathic Physicians / Orthopaedic Trauma, Allopathic & Osteopathic Physicians / Foot and Ankle Surgery. Allopathic & Osteopathic Physicians / Foot and Ankle Surgery is his primary health care specialty. Wallace, Stephen J can be contacted via phone (503) 850-9940.

Contact Information

Primary practice address
4103 Mercantile Dr Lake Oswego OR 97035-2556
Phone: (503) 850-9940
Fax: (503) 850-6709
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Orthopaedic Surgery 207X00000X MD60932486 Washington
Allopathic & Osteopathic Physicians / Orthopaedic Trauma 207XX0801X MD60932486 Washington
Allopathic & Osteopathic Physicians / Foot and Ankle Surgery 207XX0004X MD206048 Oregon

Profile Details

NPI number 1396162673
LBN Legal business name Wallace, Stephen J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2014
Last updated Oct 24th, 2021 - about 5 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1396162673 NPPES
Washington MEDICAID 1396162673

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