Juliette Elaine Waller-Rose, LICSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

LW00005812 Issued in WA

Practice address

3300 E Union St
Seattle, WA 98122-3372

Phone

(206) 399-4529

Fax

(206) 260-1777

NPI assigned

Feb 12, 2008

Last updated

Feb 12, 2008By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Elaine Waller-Rose Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Wellspring Family Services

  dba Wellspring

  • Case Management Agency
  • Seattle, WA
  • NPI 1093740573
  NPD (past)

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

{
    "created_epoch": "1202774400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1202774400000",
    "number": "1235307349",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "160 26TH AVE",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981226112",
            "telephone_number": "206-399-4529",
            "fax_number": "206-260-1777"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3300 E UNION ST",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981223372",
            "telephone_number": "206-399-4529",
            "fax_number": "206-260-1777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLER-ROSE",
        "first_name": "JULIETTE",
        "middle_name": "ELAINE",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-02-12",
        "last_updated": "2008-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WA",
            "license": "LW00005812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "ELAINE",
            "last_name": "WALLER-ROSE",
            "credential": "LICSW",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Kristen Wallace, OT
• Lorrie Kay Wallace, ARNP, LAC
• Stephanie Jeannette Wallace
• Kelsey Wallach
• Linda Diane Wallen, MD
• Bethany A Waller, ND
• Carmon Jean Waller, CPM
• Sarah Anne Waller, M.D.
• Jennifer C Wallerich, DPT
• Christopher John Wallick, PHARMD

• Clinical Social Worker in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Social Worker in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2008; 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.