Dylan Walker

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

License

THW000104032 Issued in OR

Practice address

1049 SW Baseline St
Hillsboro, OR 97123-3835

Phone

(503) 465-2749

NPI assigned

Oct 1, 2020

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Interoperability endpoints

• FHIR API: https://api.qualifacts.org/api/fhir/bridgestochange/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Bridges to Change

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Portland, OR
  • NPI 1770365413

  Peer Specialist

  NPD
• Bridges to Change

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Portland, OR
  • NPI 1326410986
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1003413261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 16576",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972920576",
            "telephone_number": "503-465-2749"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1049 SW BASELINE ST",
            "city": "HILLSBORO",
            "state": "OR",
            "postal_code": "971233835",
            "telephone_number": "503-465-2749"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "DYLAN",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-01",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": "OR",
            "license": "THW000104032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathryn Sue Waibel, RN
• Walgreen Co
• Walgreen Co
• Walgreen Co
• Colleen Walker
• Emily Ann Walker, MSCN
• Monica Lynn Walker
• Valerie Anne Walker, FNP-C
• Ethan Wallace
• Meghan Elizabeth Wallace

• All providers in Hillsboro, OR
• Peer Specialist in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.