IndividualActive
Jessica Wallace, PA-C
NPI 1306920780 · Medical Physician Assistant · Washington, DC
Provider details
- NPI number
- 1306920780
- Entity type
- Individual
- Primary specialty
- Medical Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- License
- 0010-00640 (NC)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
3020 14th St Nw
Washington, DC 20009-6865
Phone: (202) 745-4300
Fax: (202) 745-2510
Approximate (ZIP-level) locationGet directions
Mailing address
3020 14th St Nw
Washington, DC 20009-6865
Registry dates
- Enumerated
- 2006-10-24
- Last updated
- 2021-03-26
- Certified
- 2021-03-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.