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JESSICA WALLACE
NPI 1033860622
Student in an Organized Health Care Education/Training Program in Lebanon, OR

Active since January 14, 2022PECOS Enrolled
200 MULLINS DR, LEBANON, OR 97355(541) 259-0235 Get Directions Write a Review

NPPES record last updated: January 14, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Jessica Wallace NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

JESSICA WALLACE (NPI 1033860622) is an individual student in an organized health care education/training program in Lebanon, Oregon and active in the NPI registry since January 2022. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1033860622
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameJESSICA WALLACE
Location Address200 MULLINS DRLebanon, OR 97355-3983
Mailing Address200 Mullins DrLebanon, OR 97355-3983 · (503) 703-1727
Phone(541) 259-0235
Sole ProprietorYes
Enumeration DateJanuary 14, 2022
NPPES CertifiedJanuary 14, 2022
✔ NPI 1033860622 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
200 MULLINS DR, Lebanon, OR 97355
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Jessica Wallace is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JALINA MUELLER
General Practice
200 MULLINS DR
LEBANON, OR 97355
Linn County (541) 908-4101
SAISWATHI PATEL
Psychiatry & Neurology (Psychiatry)
200 MULLINS DR
LEBANON, OR 97355
Linn County (541) 259-0235
HEATHER CHRISTIANSON
Family Medicine
200 MULLINS DR
LEBANON, OR 97355
Linn County (541) 259-0200
HALEY E SANCHEZ
Internal Medicine
200 MULLINS DR
LEBANON, OR 97355
Linn County (541) 259-0235
KAYLA TRENTER
Student in an Organized Health Care Education/Training Program
200 MULLINS DR
LEBANON, OR 97355
Linn County (541) 259-0235
NGHIA LE
Student in an Organized Health Care Education/Training Program
200 MULLINS DR
LEBANON, OR 97355
Linn County (541) 259-0235
JOCELYN POWELL
Student in an Organized Health Care Education/Training Program
200 MULLINS DR
LEBANON, OR 97355
Linn County (541) 207-8321
LAUREN LIVINGSTON WOLFE
Student in an Organized Health Care Education/Training Program
200 MULLINS DR
LEBANON, OR 97355
Linn County (901) 412-2878

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Jessica Wallace's NPI number?

The NPI number for Jessica Wallace is 1033860622. It was assigned to this individual provider in the NPPES registry on January 14, 2022.

Where is Jessica Wallace located?

Jessica Wallace practices at 200 Mullins Dr, Lebanon, OR 97355. The listed phone number is (541) 259-0235.

What is Jessica Wallace's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

Is Jessica Wallace enrolled in Medicare?

Yes. Jessica Wallace is registered in the Medicare PECOS enrollment system.

When was this NPI record last updated?

The NPPES record for Jessica Wallace was last updated on January 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.