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

Dr. Ryan Myles Wallace

Individual provider Addiction Medicine (Preventive Medicine) Physician · NPI 1548695075

Dr. Ryan Myles Wallace is a Psychiatry in Anchorage, Alaska. Graduated from University of Washington School of Medicine in 2014, 12 years ago. Practices with Providence Health and Services- Washington, a 220-clinician group, works from 4 locations and accepts Medicare assignment. Licensed in Alaska and Connecticut.

Years since qualifying
12
Trained at
University of Washington School of Medicine
Licensed in
AK, CT
In the registry since
2013
Specialties on file
4

Practice location Address checks out

3760 Piper St Ste 1108
Anchorage, AK 99508-4683
Phone: (907) 212-6900
Fax: (907) 212-6936
Show map & directions

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

Additional practice locations (3)

  • 1201 E 36th Ave, Anchorage, AK 99508-4372 — (907) 562-9229
  • 55 Lock St, New Haven, CT 06511 — (203) 432-0290
  • 365 Montauk Ave, New London, CT 06320-4700 — (860) 442-0711

Specialties & licences

Psychiatry Physician (primary) Taxonomy 2084P0800X · Licence 158491 (AK)
Addiction Medicine (Preventive Medicine) Physician Taxonomy 2083A0300X · Licence 158491 (AK)
Psychiatry Physician Taxonomy 2084P0800X · Licence 55490 (CT)
Neurology Physician Taxonomy 2084N0400X · Licence 55490 (CT)

Record details

NPI number1548695075
Entity typeIndividual (Type 1)
GenderMale
Sole proprietorNo
NPI enumeratedSeptember 3, 2013
Last updated in NPPESDecember 3, 2025
Certification dateDecember 3, 2025
Mailing addressPo Box 31001-4162, Pasadena, CA 91110-4162

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPSYCHIATRY
Medical schoolUNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduated 2014 (12 years in practice)
Group practice Providence Health And Services- Washington — 220 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

Other providers in Anchorage