Dianna M Kallis, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

RN00048090 Issued in WA

Practice address

611 N 39TH Ave
Yakima, WA 98902-6348

Phone

(509) 249-1288

Fax

(509) 249-6249

NPI assigned

Aug 9, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392076800000",
    "number": "1679583702",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "611 N 39TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "98902",
            "telephone_number": "509-249-1288",
            "fax_number": "509-249-6249"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "611 N 39TH AVE",
            "city": "YAKIMA",
            "state": "WA",
            "postal_code": "989026348",
            "telephone_number": "509-249-1288",
            "fax_number": "509-249-6249"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KALLIS",
        "first_name": "DIANNA",
        "middle_name": "M",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-09",
        "last_updated": "2014-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "RN00048090",
            "primary": true
        },
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "WA",
            "license": "AP30004094",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9643420",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Cameron Bradley Justice, D.O.
• Katherine Ellen Justice, DO
• Wade W Justice, M.D.
• Justin David Moody, DDS, P.C.
• Gretchen A Kaizer, PA, RN
• Tara Whitney Kamprath, PHARM.D.
• Shefali Kanal
• Michael D Kane, MPT MOMT
• Min Jeong Kang
• Kathryn Ann Kantack

• Nurse Practitioner in Yakima, WA
• Providers in Yakima, WA by specialty
• Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2014; 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.