Alicia Jacqueline Wallace

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

30742 Issued in MD

Practice address

5530 Wisconsin Ave Ste 960
Chevy Chase, MD 20815-4315

Phone

(301) 986-4745

NPI assigned

Jan 12, 2026

Last updated

Jan 27, 2026By the provider in NPPES

Sex

Female

Sole proprietor

No

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

State licenses

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

{
    "created_epoch": "1768176000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1769472000000",
    "number": "1720946551",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1270 4TH ST NE APT 1208",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200026899",
            "telephone_number": "908-510-1348"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5530 WISCONSIN AVE STE 960",
            "city": "CHEVY CHASE",
            "state": "MD",
            "postal_code": "208154315",
            "telephone_number": "301-986-4745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALLACE",
        "first_name": "ALICIA",
        "middle_name": "JACQUELINE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-01-12",
        "last_updated": "2026-01-27",
        "certification_date": "2026-01-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MD",
            "license": "30742",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rebecca Wagner, PTA
• Andrew Leonard Wald, LCSWC
• Sonya Wali, DPM
• Ashley Walker-Smith, APRN
• Robert Edward Walker, MD
• Godiza Marie Wallace
• Ryan McDonald Walley, M.D.
• Ashley Tremblay Walton, PA-C
• Angela Wang
• Judy Wang, LCPC, CPC

• Physical Therapist in Chevy Chase, MD
• Providers in Chevy Chase, MD by specialty
• Physical Therapist in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 27, 2026; 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.