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

Individual provider Student in an Organized Health Care Education/Training Program · NPI 1033860622

Jessica Wallace is a Student in an Organized Health Care Education/Training Program in Lebanon, Oregon. Practices as a sole proprietor. Registered with an NPI since 2022.

In the registry since
2022
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Practice location Address checks out

200 Mullins Dr
Lebanon, OR 97355-3983
Phone: (541) 259-0235
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Student in an Organized Health Care Education/Training Program (primary) Taxonomy 390200000X

Record details

NPI number1033860622
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJanuary 14, 2022
Last updated in NPPESJanuary 14, 2022
Certification dateJanuary 14, 2022
Mailing address200 Mullins Dr, Lebanon, OR 97355-3983

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