Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1780210658 Individual Practitioner Male Practitioner

Dr. Jordan Scott Wallace , MD

Pediatrics • Snoqualmie, WA

Professional Overview & Biography Verified Profile Summary

Dr. Jordan Wallace, MD is a registered healthcare professional specializing in Pediatrics in Snoqualmie, WA. Practice services are available at 9801 FRONTIER AVE SE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

9801 Frontier Ave Se

Snoqualmie, WA 980655200

Telephone 4258312300
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Pediatrics in Snoqualmie, WA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 10.5 Yrs
State Avg: 18.8 Yrs
Regional Practice Density
4 Specialists

Practicing in Snoqualmie, WA (1802 Statewide)

Telehealth Adoption Rate
0.0% 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

CMS Verified: 2025-10-15
Pediatrics Primary Specialty

NUCC Taxonomy Code: 208000000X

State License WA MD61570069

A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Practice Associates & Co-Workers

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

36 Associated Practitioners
Yvette Artman , MS, CCC-SLP

Speech-Language Pathologist

NPI 1003251232

Master of Science, Speech-Language Pathologist (Certificate of Clinical Competence)

NPI 1083637110

Doctor of Medicine (M.D.)

Dima Karim

Speech-Language Pathologist

NPI 1104600584
Dr. Jonathan Halper , MD

Emergency Medicine

NPI 1114952082

Doctor of Medicine (M.D.)

Emilia Lewis , PA-C

Physician Assistant

NPI 1144714643

Physician Assistant (Certified)

Dr. Kimberly Witkop , MD

Internal Medicine

NPI 1194772046

Doctor of Medicine (M.D.)

Career & Practice History Timeline

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

13 Historical Events
📍
Updated Business Mailing Address October 15, 2025

Registered at 9801 FRONTIER AVE SE, SNOQUALMIE, WA 980655200 (Tel: 4258312300)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 15, 2025

Pediatrics (License #MD61570069 in WA)

📍
Updated Practice Location September 10, 2024

Registered at 9801 FRONTIER AVE SE, SNOQUALMIE, WA 980655200 (Tel: 4258312300)

📍
Updated Practice Location August 14, 2023

Registered at 725 WELCH RD, PALO ALTO, CA 943041601 (Tel: 6504978000)

📍
Updated Business Mailing Address August 14, 2023

Registered at 725 WELCH RD, PALO ALTO, CA 943041601 (Tel: 6504978000)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) August 14, 2023

Pediatrics (License #A188568 in CA)

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) June 24, 2020

Pediatrics (License #ML61058571 in WA)

NPI Profile Active March 22, 2020

NPI status registered as active in NPPES database

📍
Updated Practice Location March 22, 2020

Registered at 4800 SAND POINT WAY NE # OC.7830, SEATTLE, WA 981053901 (Tel: 2069872525)

📍
Updated Business Mailing Address March 22, 2020

Registered at 4800 SAND POINT WAY NE, OC.7.830, SEATTLE, WA 98105

👤
Provider Name / Credentials Updated March 22, 2020

Recorded as JORDAN WALLACE, MD

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) March 22, 2020

Student in an Organized Health Care Education/Training Program

🟢
Initial NPI Registration & Enumeration March 22, 2020

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

0 Reviews
No patient reviews submitted yet for Dr. Jordan Wallace. Be the first to share your experience!

Sign in to leave a review for Dr. Jordan Wallace

Only verified registered users can submit ratings, post feedback, and upload facility photos.

NPI Administrative Meta

NPI Number: 1780210658
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: March 22, 2020
Last Update: October 15, 2025
Sole Proprietor: No

Mailing Address

9801 Frontier Ave Se

Snoqualmie, WA 980655200

Phone: 4258312300

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.