Daniel Wallach

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

9921 Issued in OR

Practice address

2621 NE 134TH St Ste 140
Vancouver, WA 98686-3036

Phone

(360) 504-0122

Fax

(360) 839-1354

NPI assigned

Aug 28, 2016

Sex

Male

Sole proprietor

No

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": "1472342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1737331200000",
    "number": "1104372473",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "823 SE 36TH ST",
            "city": "BATTLE GROUND",
            "state": "WA",
            "postal_code": "986043197",
            "telephone_number": "541-373-7880"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2621 NE 134TH ST STE 140",
            "city": "VANCOUVER",
            "state": "WA",
            "postal_code": "986863036",
            "telephone_number": "360-504-0122",
            "fax_number": "360-839-1354"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "717 Santa Ana Ave",
            "address_purpose": "LOCATION",
            "city": "Sacramento",
            "state": "CA",
            "postal_code": "958381822",
            "country_code": "US",
            "telephone_number": "916-710-3851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALLACH",
        "first_name": "DANIEL",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-08-28",
        "last_updated": "2025-01-20",
        "certification_date": "2025-01-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OR",
            "license": "9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Christine Wall, RN
• Mary Wallace
• Skyler Wallace
• Tristin HC Wallace, ND
• Vanessa Wallace
• Anna Waller, CFY-SLP
• Sonia Waller
• Danielle Marie Walling, L.M.T
• Amanda Wallinger
• Joanne M Wallis, PNP

• Physical Therapy Assistant in Vancouver, WA
• Providers in Vancouver, WA by specialty
• Physical Therapy Assistant in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2025; 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.