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

MS. Jennifer Wallace

Individual provider Home Health Agency · NPI 1356968440

MS. Jennifer Wallace is an Undefined Non-Physician Type (Specify) in Everett, Washington. Qualified in 2016, 10 years ago. Practices as a sole proprietor. Licensed in Arizona and Washington.

Years since qualifying
10
Licensed in
AZ, WA
In the registry since
2020
Specialties on file
13

Practice location Address checks out

3409 McDougall Ave Ste 200
Everett, WA 98201-5040
Phone: (480) 685-7530
Fax: (480) 900-8853
Show map & directions

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

Specialties & licences

Phlebotomy Technician (primary) Taxonomy 246RP1900X
Home Health Agency Taxonomy 251E00000X
Clinical Medical Laboratory Taxonomy 291U00000X · Licence 1568068609 (AZ)
Phlebotomy Technician Taxonomy 246RP1900X · Licence PC61547365 (WA)
Clinic/Center Taxonomy 261Q00000X
Home Health Aide Taxonomy 374U00000X · Licence EXPERIENCED (AZ)
Health Service Clinic/Center Taxonomy 261QH0100X
Home Health Aide Taxonomy 374U00000X (AZ)
Other Technician Taxonomy 247200000X · Licence 032016 (AZ)
Clinical Medical Laboratory Taxonomy 291U00000X · Licence 03D2197602 (AZ)
Nursing Care Agency Taxonomy 251J00000X · Licence 03D2197602 (AZ)
Driver Taxonomy 172A00000X · Licence WDL722Z7B13B (WA)
Technician/Technologist Taxonomy 156F00000X

Record details

NPI number1356968440
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorYes
NPI enumeratedJuly 6, 2020
Last updated in NPPESApril 14, 2026
Certification dateApril 14, 2026
Mailing address3409 McDougall Ave Ste 200, Everett, WA 98201-5040

Medicare enrollment

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

Medicare specialtyUNDEFINED NON-PHYSICIAN TYPE (SPECIFY)
Medical schoolOTHER
Graduated 2016 (10 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

Other providers in Everett