Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dereka Wallace, RN

Individual provider Emergency Registered Nurse · NPI 1346040649

Dereka Wallace, RN is an Emergency Registered Nurse in Puyallup, Washington. Licensed in Washington. Registered with an NPI since 2025.

Licensed in
WA
In the registry since
2025
What do these letters mean?
RN — Registered Nurse
A licensed nurse who completed a nursing degree and passed the NCLEX-RN examination.

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Practice location Address checks out

401 15th Ave SE
Puyallup, WA 98372-3715
Phone: (253) 697-4000
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Emergency Registered Nurse (primary) Taxonomy 163WE0003X · Licence 61519413 (WA)

Record details

NPI number1346040649
Entity typeIndividual (Type 1)
GenderFemale
Credentials RN
Sole proprietorNo
NPI enumeratedMarch 17, 2025
Last updated in NPPESMarch 17, 2025
Certification dateMarch 16, 2025
Mailing address401 15th Ave Se, Puyallup, WA 98372-3715

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