DR. RYAN MYLES WALLACE NPI 1548695075

NPI Information

  • NPI: 1548695075
  • Provider Name: DR. RYAN MYLES WALLACE
  • Classification: Psychiatry & Neurology - 2084P0800X
  • Specialization: Psychiatry
  • Entity Type: Individual
  • PECOS Registration: Yes
  • Address: 3760 PIPER ST STE 1108
    ANCHORAGE, AK
    ZIP 99508
  • Phone: (907) 212-6900

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NPI Details

DR. Ryan Myles Wallace is a psychiatry psychiatry neurology in Anchorage, AK with 12 years of experience. The provider is a Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems. DR. Ryan Myles Wallace NPI is 1548695075. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

Education
Medical School: UNIVERSITY OF WASHINGTON SCHOOL OF MEDICINE
Graduation Year:2014

The provider's business location address is:

3760 PIPER ST STE 1108
ANCHORAGE, AK
ZIP 99508-683
Phone: (907) 212-6900
Fax: (907) 212-6936

The NPI 1548695075 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 9/3/2013 and was last updated on 12/3/2025.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
12083A0300XPreventive MedicineAddiction Medicine158491ALASKANo
22084P0800XPsychiatry & NeurologyPsychiatry158491ALASKAYes
32084P0800XPsychiatry & NeurologyPsychiatry55490CONNECTICUTNo
42084N0400XPsychiatry & NeurologyNeurology55490CONNECTICUTNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
11709157MEDICAIDALASKA
2008056168MEDICAIDCONNECTICUT
3500000315MEDICAIDCONNECTICUT
4008076123MEDICAIDCONNECTICUT
5004082286MEDICAIDCONNECTICUT
6008022626MEDICAIDCONNECTICUT

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/21/2025

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