NPIMap

Individual provider Active NPI

Wayne Daly

  • Prosthetist
  • Mountlake Terrace, WA
National Provider Identifier
1184814154
Registry record updated Oct 22, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
ProsthetistTaxonomy code 224P00000X
License
PS00000011 Issued in WA
Practice address
6405 218TH St SW
Suite 301
Mountlake Terrace, WA 98043-2180
Phone
(425) 771-0797
Fax
(206) 219-1144
NPI assigned
Jul 26, 2007
Last updated
Oct 22, 2012By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 22, 2012

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Orthotist 222Z00000X OI00000010 WA
Prosthetist 224P00000X PS00000011 WA Primary

Addresses

Primary practice location

6405 218TH St SW
Suite 301
Mountlake Terrace, WA 98043-2180

Mailing address

6405 218TH St SW
Suite 301
Mountlake Terrace, WA 98043-2180
Phone (425) 771-0797

Other identifiers 1

IdentifierTypeStateIssuer
9015561MedicaidWA

Other names 1

  • Mr. Wayne Daly Professional name

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

State licenses

LicenseStateTypeSpecialty
OI00000010WAMDOrthotist
PS00000011WAMDProsthetist

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1185408000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1350864000000",
    "number": "1184814154",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 218TH ST SW",
            "address_2": "SUITE 301",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432180",
            "telephone_number": "425-771-0797",
            "fax_number": "206-219-1144"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6405 218TH ST SW",
            "address_2": "SUITE 301",
            "city": "MOUNTLAKE TERRACE",
            "state": "WA",
            "postal_code": "980432180",
            "telephone_number": "425-771-0797",
            "fax_number": "206-219-1144"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DALY",
        "first_name": "WAYNE",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-07-26",
        "last_updated": "2012-10-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "WA",
            "license": "OI00000010",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "WA",
            "license": "PS00000011",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9015561",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "WAYNE",
            "last_name": "DALY",
            "prefix": "MR.",
            "credential": "C.P.O.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Mountlake Terrace, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2012; 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.