Individual provider Active NPI

Danhua K Wallace, ARNP

  • Nurse Practitioner
  • Coupeville, WA
National Provider Identifier
1134320401
Registry record updated Dec 9, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
AP30006550 Issued in WA
Practice address
101 N. Main Street
Coupeville, WA 98239
Phone
(360) 678-7656
NPI assigned
May 31, 2007
Last updated
Dec 9, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 9, 2014

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X AP30006550 WA Primary
Nurse Practitioner 363L00000X H138175 IA

Addresses

Primary practice location

101 N. Main Street
Coupeville, WA 98239

Mailing address

101 N. Main Street
Coupeville, WA 98239

Other identifiers 2

IdentifierTypeStateIssuer
P01375308OtherIARR MEDICARE
1134320401MedicaidIA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070725000774 WA Practitioner - Nurse Practitioner 4587765128 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2003
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

1717 S J St
Tacoma, WA 98405-4933

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP30006550WAMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
South Sound Inpatient Physicians PLLC Nurse Practitioner Current Accepting new patients
Franciscan Medical Group CurrentSince Apr 1, 2019 Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Jan 1, 2017 Accepting new patients
Franciscan Medical Group CurrentSince Apr 1, 2019 Accepting new patients
South Sound Inpatient Physicians PLLC CurrentSince Jan 1, 2017 Accepting new patients
Franciscan Medical Group Past Accepting new patients

Locations

16251 Sylvester Rd SW
Burien, WA 98166
Phone (206) 244-9970

101 N Main St
Coupeville, WA 98239
Phone (360) 678-7656

1455 Battersby Ave
Enumclaw, WA 98022
Phone (253) 552-5615

34503 9th Ave S
Ste 130
Federal Way, WA 98003
Phone (253) 835-5340

34515 9th Ave S
Federal Way, WA 98003
Phone (253) 835-8100

34515 9th Ave S
#136
Federal Way, WA 98003

11567 Canterwood Blvd
Gig Harbor, WA 98332
Phone (253) 530-2000

407 14th Ave SE
Puyallup, WA 98372
Phone (253) 697-4000

11315 Bridgeport Way SW
Tacoma, WA 98499
Phone (253) 588-1711

1717 S J St
Tacoma, WA 98405
Phone (253) 426-4101

1717 S J St
Stop 136
Tacoma, WA 98405

1812 S J St
Ste 120
Tacoma, WA 98405
Phone (253) 428-2200

Organizations & group practices 6

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

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1180569600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1418083200000",
    "number": "1134320401",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 N. MAIN STREET",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "98239"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 N. MAIN STREET",
            "city": "COUPEVILLE",
            "state": "WA",
            "postal_code": "98239",
            "telephone_number": "360-678-7656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "DANHUA",
        "middle_name": "K",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-31",
        "last_updated": "2014-12-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30006550",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "H138175",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "P01375308",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1134320401",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Coupeville, WA

Sources for this page

Verify at the official NPI Registry.