Christine Leigh Wallin

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

TSLP-3338 Issued in ID

Practice address

3169 S Bown Way
Boise, ID 83706-5400

Phone

(208) 433-9152

NPI assigned

Jan 3, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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

• Riversong Speech and Language

  • Speech-Language Pathologist
  • Boise, ID
  • NPI 1992309496
  NPD Authorized official
• Laurie Appel Otrl PLLC

  • Occupational Therapist
  • Boise, ID
  • NPI 1205027182
  NPD (past)

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

{
    "created_epoch": "1514937600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1514937600000",
    "number": "1154838936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 W PLEASANTON AVE",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837023835",
            "telephone_number": "928-600-4948"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3169 S BOWN WAY",
            "city": "BOISE",
            "state": "ID",
            "postal_code": "837065400",
            "telephone_number": "208-433-9152"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIN",
        "first_name": "CHRISTINE",
        "middle_name": "LEIGH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-01-03",
        "last_updated": "2018-01-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "ID",
            "license": "TSLP-3338",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jonathan Wesley Wallace, MD
• Rhianna Wallace, MSOT
• Sean Wallaszek
• Kathryn Lynette Wallentine, PTA
• William Taylor Wallick
• Kristopher Dwayne Wallin, COTA/L
• Nathan Wallin, RN
• Kent Wallinga, DPT
• Kimberly Wallis-Rucklos, MA CCC SLP
• Walmart Inc.

• Speech-Language Pathologist in Boise, ID
• Providers in Boise, ID by specialty
• Speech-Language Pathologist in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 3, 2018; 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.