Kelly Walling, LCP

Primary specialty

ProsthetistTaxonomy code 224P00000X

License

60764098 Issued in WA

Practice address

12039 NE 128TH St Ste 140
Kirkland, WA 98034-3030

Phone

(425) 814-3258

NPI assigned

Aug 10, 2017

Sex

Female

Sole proprietor

No

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

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1502323200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1699290684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12039 NE 128TH ST STE 140",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12039 NE 128TH ST STE 140",
            "city": "KIRKLAND",
            "state": "WA",
            "postal_code": "980343030",
            "telephone_number": "425-814-3258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLING",
        "first_name": "KELLY",
        "credential": "LCP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-10",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "222Z00000X",
            "taxonomy_group": "",
            "desc": "Orthotist",
            "state": "WA",
            "license": "60816058",
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": "WA",
            "license": "60764098",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Eleanor Hollis Wall
• Peter Davis Wall, MD
• Alisha Ashurst Wallace, PA-C
• Judith Ann Wallace, LMP
• Brittney Wallin
• Brooke Walsh
• Jillian Rogers Walsh, CNM, WHNP
• Dennis D. Waltman, M.D.
• Dean C. Walund, MD
• Luke Earle Walwick

• Prosthetist in Kirkland, WA
• Providers in Kirkland, WA by specialty
• Prosthetist in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.