Individual provider Active NPI

Teresa Walker, M.S., ATC

  • Athletic Trainer
  • Lynnwood, WA
National Provider Identifier
1114373792
Registry record updated May 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Athletic TrainerTaxonomy code 2255A2300X
License
A160619109 Issued in WA
Practice address
19217 36TH Ave W
Suite 102
Lynnwood, WA 98036-5751
Phone
(425) 670-9991
NPI assigned
May 12, 2016
Last updated
May 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 12, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X A160619109 WA Primary

Addresses

Primary practice location

19217 36TH Ave W
Suite 102
Lynnwood, WA 98036-5751

Mailing address

19217 36TH Ave W
Suite 102
Lynnwood, WA 98036-5751
Phone (425) 670-9991

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
A160619109WAMDAthletic Trainer

NPI Registry JSON

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1463011200000",
    "number": "1114373792",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "19217 36TH AVE W",
            "address_2": "SUITE 102",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365751",
            "telephone_number": "425-670-9991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "19217 36TH AVE W",
            "address_2": "SUITE 102",
            "city": "LYNNWOOD",
            "state": "WA",
            "postal_code": "980365751",
            "telephone_number": "425-670-9991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "TERESA",
        "credential": "M.S., ATC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2016-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A160619109",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lynnwood, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 12, 2016; 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.