Caitlin Anne Gallup, LAT, ATC, PTA

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

A160184177 Issued in WA

Practice address

4703 Pacific Hwy E Ste B
Fife, WA 98424

Phone

(253) 926-8212

NPI assigned

Aug 24, 2017

Last updated

Jun 11, 2018By 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": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528675200000",
    "number": "1730606328",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1217 S 240TH ST",
            "city": "DES MOINES",
            "state": "WA",
            "postal_code": "981983837"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4703 PACIFIC HWY E STE B",
            "city": "FIFE",
            "state": "WA",
            "postal_code": "98424",
            "telephone_number": "253-926-8212"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GALLUP",
        "first_name": "CAITLIN",
        "middle_name": "ANNE",
        "credential": "LAT, ATC, PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2018-06-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "WA",
            "license": "A160184177",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Elizabeth Gienger, SLPA
• Lavina Giorgio
• Glorianne D. Walker, DMD, PLLC

• Athletic Trainer in Fife, WA
• Providers in Fife, WA by specialty
• Athletic Trainer in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2018; 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.