Jay Taran Walko, RN, MSN, AGPCNP-C

Primary specialty

Gerontology Nurse PractitionerTaxonomy code 363LG0600X

License

201906834NP-PP Issued in OR

Practice address

17727 E Burnside St
Portland, OR 97233-4803

Phone

(503) 215-9800

NPI assigned

Jan 11, 2018

Sex

Unspecified or another gender identity

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other names 1

• Julie Ann Walko Former name

Medicare fee-for-service enrollment

Enrolled in OR

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing, Nurse Practitioner, Registered Nurse

State licenses

Interoperability endpoints

• Direct secure messaging: jwalko1031462@oc.providencedirect.org

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

{
    "created_epoch": "1515628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729814400000",
    "number": "1558879502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17727 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972334803",
            "telephone_number": "503-215-9800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17727 E BURNSIDE ST",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972334803",
            "telephone_number": "503-215-9800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKO",
        "first_name": "JAY",
        "middle_name": "TARAN",
        "credential": "RN, MSN, AGPCNP-C",
        "sole_proprietor": "NO",
        "sex": "X",
        "enumeration_date": "2018-01-11",
        "last_updated": "2024-10-25",
        "certification_date": "2024-10-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "OR",
            "license": "201243683RN",
            "primary": false
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "OR",
            "license": "201906834NP-PP",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "OR",
            "license": "201906834NP-PP",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "WALKO",
            "middle_name": "ANN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tracy Walker, MD
• Trina Lashawn Walker, RN
• William Walker Jr., LCSW
• Marilyn Mills Walkey, MD, LAC
• Kalen Walkington, RN
• Hana Safic Walkup, D.M.D
• Andrea Jane Wall, OTR/L
• Kimberly Lynn Wall, LCSW
• Michael Wall
• Michael Abraham Wall, MD

• Gerontology Nurse Practitioner in Portland, OR
• Providers in Portland, OR by specialty
• Gerontology Nurse Practitioner in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 25, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.