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

Jordan Scott Wallace, MD

Individual provider Pediatrics Physician · NPI 1780210658

Jordan Scott Wallace, MD is a Pediatrics Physician in Snoqualmie, Washington. Licensed in Washington. Registered with an NPI since 2020.

Licensed in
WA
In the registry since
2020
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

9801 Frontier Ave SE
Snoqualmie, WA 98065-5200
Phone: (425) 831-2300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Pediatrics Physician (primary) Taxonomy 208000000X · Licence MD61570069 (WA)

Record details

NPI number1780210658
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 22, 2020
Last updated in NPPESOctober 15, 2025
Certification dateOctober 15, 2025
Mailing address9801 Frontier Ave Se, Snoqualmie, WA 98065-5200

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