Kayla Wicks, CPO, LPO

Primary specialty

OrthotistTaxonomy code 222Z00000X

License

OI61230221 Issued in WA

Practice address

1516 Hudson St Ste 105
Longview, WA 98632-3046

Phone

(360) 423-6049

NPI assigned

Nov 11, 2021

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1636588800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1636588800000",
    "number": "1033875240",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "830 GISH RD",
            "city": "ONALASKA",
            "state": "WA",
            "postal_code": "985709529",
            "telephone_number": "253-797-5163"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1516 HUDSON ST STE 105",
            "city": "LONGVIEW",
            "state": "WA",
            "postal_code": "986323046",
            "telephone_number": "360-423-6049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WICKS",
        "first_name": "KAYLA",
        "credential": "CPO, LPO",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-11-11",
        "last_updated": "2021-11-11",
        "certification_date": "2021-11-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "WA",
            "license": "PS61132736",
            "primary": false
        },
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "WA",
            "license": "OI61230221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Robert C White, SUDPT
• Everett Lawrence Whiteside, RN
• Heather Whitney
• Paul L Whiton
• Jamie Wick, MS
• Valerie N Wiese, BA, R-AAC
• Sarah Wilber, PA-C
• Mercedes Darlene Wilder, LICSW
• Faith Ann Wilfley, M.D.
• Alisa L Wilkinson

• Orthotist in Longview, WA
• Providers in Longview, WA by specialty
• Orthotist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 11, 2021; 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.