Wallace Wilkins, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

1454 Issued in WA

Practice address

901 Boren Ave Ste 1300
Seattle, WA 98104-3509

Phone

(206) 284-1943

NPI assigned

Nov 9, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Jul 1, 2015 through Jul 1, 2027

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1668643200000",
    "number": "1508936931",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "620 TERRY AVE UNIT 1907",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981042284",
            "telephone_number": "206-284-1943",
            "fax_number": "206-284-1943"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "901 BOREN AVE STE 1300",
            "city": "SEATTLE",
            "state": "WA",
            "postal_code": "981043509",
            "telephone_number": "206-284-1943"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKINS",
        "first_name": "WALLACE",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-09",
        "last_updated": "2022-11-17",
        "certification_date": "2022-11-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TA0400X",
            "taxonomy_group": "",
            "desc": "Psychologist, Addiction (Substance Use Disorder)",
            "state": "WA",
            "license": "1454",
            "primary": false
        },
        {
            "code": "103TB0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Cognitive & Behavioral",
            "state": "WA",
            "license": "1454",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "WA",
            "license": "1454",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dawnelle Katherina Wilkie, MFA
• Michael Wilkin, AAC
• Marianne Elizabeth Wilkins, PA-C
• Rebecca Jean Wilkins
• Tameeka Wilkins
• Daniel V. Wilkinson, MD
• Karen Wilkinson, ARNP
• Lisa Wilkinson, MA, LMHC
• Robyn Wilkinson
• Wendy Ruth Wilkinson, MD

• Clinical Psychologist in Seattle, WA
• Providers in Seattle, WA by specialty
• Clinical Psychologist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.