Walter Merle Wallis, MD

Primary specialty

Child & Adolescent Psychiatry PhysicianTaxonomy code 2084P0804X

License

MD00014381 Issued in WA

Practice address

4526 Federal Ave
BLDG 9
Everett, WA 98203

Phone

(425) 349-6320

Fax

(425) 349-6325

NPI assigned

Oct 3, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Medicine

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 and National Provider Directory roles.

• Compass Health

  • Community/Behavioral Health Agency
  • Everett, WA
  • NPI 1730136201
  NPD (past)

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1548355191",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4526 FEDERAL AVE",
            "address_2": "BLDG 9",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98203",
            "telephone_number": "425-349-6320",
            "fax_number": "425-349-6325"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4526 FEDERAL AVE",
            "address_2": "BLDG 9",
            "city": "EVERETT",
            "state": "WA",
            "postal_code": "98203",
            "telephone_number": "425-349-6320",
            "fax_number": "425-349-6325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLIS",
        "first_name": "WALTER",
        "middle_name": "MERLE",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2084P0804X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Child & Adolescent Psychiatry",
            "state": "WA",
            "license": "MD00014381",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lorreta Akinyi Wallen
• Jacob Waller, D.C.
• Eric Wallin
• Jonathan Thomas Wallis, MA, LMHCA
• Megan K Wallis, MSW
• Daniel Wallulis
• Walmart
• Walmart Inc.
• Walmart Inc.
• Devoney Syrene Walmer, LMT

• Child & Adolescent Psychiatry Physician in Everett, WA
• Providers in Everett, WA by specialty
• Child & Adolescent Psychiatry Physician in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.