Active NPI
Tristin HC Wallace, ND
- Naturopath
- Vancouver, WA
National Provider Identifier
1396921722
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Naturopath
- License
- NT 60083023
- Practice address
- 14201 NE 20TH Ave
Suite 1102
Vancouver, WA 98686-6410 - Phone
- (360) 882-7373
- Fax
- (360) 882-7673
- NPI assigned
- Jan 16, 2008
- 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 |
|---|---|---|---|---|
| Naturopath | 175F00000X | NT 60083023 | WA | Primary |
Addresses
Primary practice location
14201 NE 20TH Ave
Suite 1102
Vancouver, WA 98686-6410
Mailing address
14201 NE 20TH Ave
Suite 1102
Vancouver, WA 98686-6410
Phone (360) 882-7373
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 |
|---|---|---|---|
| NT 60083023 | WA | MD | Naturopath |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1200441600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348099200000",
"number": "1396921722",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14201 NE 20TH AVE",
"address_2": "SUITE 1102",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986866410",
"telephone_number": "360-882-7373",
"fax_number": "360-882-7673"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "14201 NE 20TH AVE",
"address_2": "SUITE 1102",
"city": "VANCOUVER",
"state": "WA",
"postal_code": "986866410",
"telephone_number": "360-882-7373",
"fax_number": "360-882-7673"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "TRISTIN",
"middle_name": "HC",
"name_prefix": "Dr.",
"credential": "ND",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-01-16",
"last_updated": "2012-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "175F00000X",
"taxonomy_group": "",
"desc": "Naturopath",
"state": "WA",
"license": "NT 60083023",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Vancouver, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 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.