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Active NPI 1770662835 Individual Practitioner Male Practitioner

Kent William Wallace , PA-C, ARNP

Physician Assistant - Surgical • Everett, WA

Professional Overview & Biography Verified Profile Summary

Kent Wallace, PA-C, ARNP is a registered healthcare professional specializing in Physician Assistant - Surgical in Everett, WA. Practice services are available at 1321 COLBY AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

1321 Colby Ave
Medical Staff Office (Pmg)

Everett, WA 982011665

Telephone 4252612000
Associated Practice Facility / Clinic
🏢 Credena Health Llc Facility NPI 1013906528

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant - Surgical in Everett, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.0 Yrs
State Avg: 13.2 Yrs
Regional Practice Density
32 Specialists

Practicing in Everett, WA (612 Statewide)

Telehealth Adoption Rate
6.2% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant - Surgical Primary Specialty

NUCC Taxonomy Code: 363AS0400X

State License WA PA10000442

Definition to come...

Additional State Medicaid & Healthcare Payer Identifiers

Commercial Insurance / Payer ID Labor And Industries
124775 (WA)
Commercial Insurance / Payer ID Regence
WA6512 (WA)
Commercial Insurance / Payer ID Railroad Medicare
8803430 (WA)

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

40 Associated Practitioners
Dr. Samuel Guyer , MD

Surgery - Trauma Surgery

NPI 1003312992

Doctor of Medicine (M.D.)

NPI 1003513946
Dr. Lindsy Alanis , MD

Internal Medicine

NPI 1003826603

Doctor of Medicine (M.D.)

NPI 1003911744

Doctor of Medicine (M.D.)

NPI 1013943752

Doctor of Medicine (M.D.)

Dr. Daniel Zak , MD

Emergency Medicine

NPI 1013965490

Doctor of Medicine (M.D.)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active February 06, 2015

NPI status registered as active in NPPES database

📍
Updated Practice Location February 06, 2015

Registered at 1321 COLBY AVE, MEDICAL STAFF OFFICE (PMG), EVERETT, WA 982011665 (Tel: 4252612000)

📍
Updated Business Mailing Address February 06, 2015

Registered at PO BOX 3360, PROVIDENCE HEALTH & SERVICES, PORTLAND, OR 972083360 (Tel: 8663662983)

👤
Provider Name / Credentials Updated February 06, 2015

Recorded as KENT WALLACE, PA-C, ARNP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) February 06, 2015

Physician Assistant (License #PA10000442 in WA)

🟢
Initial NPI Registration & Enumeration November 02, 2006

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1770662835
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 02, 2006
Last Update: February 06, 2015
Sole Proprietor: No

Mailing Address

Po Box 3360, Providence Health & Services

Portland, OR 972083360

Phone: 8663662983

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.