Active NPI
Karlen Marie Wallace, PT, DPT
- Physical Therapist
- Spokane, WA
National Provider Identifier
1336663194
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- PT60707760
- Practice address
- 6025 N Assembly St
Spokane, WA 99205-7674 - Phone
- (509) 326-8282
- NPI assigned
- Aug 2, 2017
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PT60707760 | WA | Primary |
Addresses
Primary practice location
6025 N Assembly St
Spokane, WA 99205-7674
Mailing address
13005 W Pacific Ave
Airway Heights, WA 99001-5291
Phone (304) 231-4162
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
| License | State | Type | Specialty |
|---|---|---|---|
| PT60707760 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1501632000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1696377600000",
"number": "1336663194",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "13005 W PACIFIC AVE",
"city": "AIRWAY HEIGHTS",
"state": "WA",
"postal_code": "990015291",
"telephone_number": "304-231-4162"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "6025 N ASSEMBLY ST",
"city": "SPOKANE",
"state": "WA",
"postal_code": "992057674",
"telephone_number": "509-326-8282"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "KARLEN",
"middle_name": "MARIE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-02",
"last_updated": "2023-10-04",
"certification_date": "2023-10-04",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "PT60707760",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Spokane, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 4, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.