ELLIE WALLACE
NPI 1306559570
Student in an Organized Health Care Education/Training Program in Lebanon, OR

Active since January 03, 2023
200 MULLINS DR, LEBANON, OR 97355(541) 259-0235 Get Directions Write a Review

NPPES record last updated: January 3, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Ellie Wallace NPPES

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

ELLIE WALLACE (NPI 1306559570) is an individual student in an organized health care education/training program in Lebanon, Oregon and active in the NPI registry since January 2023.

NPPES Registry Identity

NPI1306559570
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameELLIE WALLACE
Location Address200 MULLINS DRLebanon, OR 97355-3983
Mailing Address200 Mullins DrLebanon, OR 97355-3983 · (541) 259-0235
Sole ProprietorYes
Enumeration DateJanuary 3, 2023
NPPES CertifiedJanuary 3, 2023
NPI 1306559570 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

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

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.

General Practice
200 MULLINS DR
LEBANON, OR 97355
Psychiatry & Neurology (Psychiatry)
200 MULLINS DR
LEBANON, OR 97355
Family Medicine
200 MULLINS DR
LEBANON, OR 97355
Internal Medicine
200 MULLINS DR
LEBANON, OR 97355
Student in an Organized Health Care Education/Training Program
200 MULLINS DR
LEBANON, OR 97355
Student in an Organized Health Care Education/Training Program
200 MULLINS DR
LEBANON, OR 97355
Student in an Organized Health Care Education/Training Program
200 MULLINS DR
LEBANON, OR 97355
Student in an Organized Health Care Education/Training Program
200 MULLINS DR
LEBANON, OR 97355

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 Ellie Wallace's NPI number?

The NPI number for Ellie Wallace is 1306559570. It was assigned to this individual provider in the NPPES registry on January 3, 2023.

Where is Ellie Wallace located?

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

What is Ellie Wallace's specialty?

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

When was this NPI record last updated?

The NPPES record for Ellie Wallace was last updated on January 3, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 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.