National Provider Identifier Database

JENNIFER WALLACE
Phlebotomy

Contact Information

JENNIFER WALLACE
3409 MCDOUGALL AVE STE 200
EVERETT, WA  98201-5040
Phone: 480-685-7530
Fax: 480-900-8853
Website:
Specialty Taxonomy Code
* Phlebotomy 246RP1900X
Clinic/Center 261Q00000X
Clinical Medical Laboratory 291U00000X
Driver 172A00000X
Health Service 261QH0100X
Home Health 251E00000X
Home Health Aide 374U00000X
Nursing Care 251J00000X
Technician, Other 247200000X
Technician/Technologist 156F00000X

* Indicates primary specialty

NPI Profile & details for JENNIFER WALLACE

NPI Number 1356968440
Credentials
Entity Individual
Enumeration date 07/06/2020
Last updated 04/14/2026 - About 2 months ago
Sole proprietor1 Yes
Identifiers
  • AZ License #: 032016
  • AZ License #: 03D2197602
  • AZ License #: 1568068609
  • AZ License #: EXPERIENCED
  • WA License #: PC61547365
  • WA License #: WDL722Z7B13B
  • WA Other: 50D2322596 CLIA
  • WA Other: MTSW.FS.61686172 MEDICAL TEST SITE CLIA
  • WA Other: PC61547365 PHLEBOTOMY LICENSE
Hospital affiliation n/a

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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