Active NPI
Valla Penrose Walker, PSY.D.
- Clinical Psychologist
- Everett, WA
National Provider Identifier
1043458904
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- PY60759292
- Practice address
- 1721 Hewitt Ave Ste 518
Everett, WA 98201-3546 - Phone
- (425) 595-3511
- Fax
- (626) 628-3113
- NPI assigned
- Jan 30, 2009
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | PSY22441 | CA | |
| Clinical Psychologist | 103TC0700X | PY60759292 | WA | Primary |
Addresses
Primary practice location
1721 Hewitt Ave Ste 518
Everett, WA 98201-3546
Mailing address
1721 Hewitt Ave Ste 518
Everett, WA 98201-3546
Phone (425) 595-3511
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 1, 2025 through Apr 1, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PSY22441 | CA | MD | Clinical Psychologist |
| PY60759292 | WA | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1233273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1525132800000",
"number": "1043458904",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1721 HEWITT AVE STE 518",
"city": "EVERETT",
"state": "WA",
"postal_code": "982013546",
"telephone_number": "425-595-3511",
"fax_number": "626-628-3113"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1721 HEWITT AVE STE 518",
"city": "EVERETT",
"state": "WA",
"postal_code": "982013546",
"telephone_number": "425-595-3511",
"fax_number": "626-628-3113"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALKER",
"first_name": "VALLA",
"middle_name": "PENROSE",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-01-30",
"last_updated": "2018-05-01",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "CA",
"license": "PSY22441",
"primary": false
},
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "WA",
"license": "PY60759292",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Everett, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 1, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.