Active NPI
Katherine Ann Wallace, PT
- Physical Therapist
- Seattle, WA
National Provider Identifier
1750438883
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2186
- Practice address
- 5901 Roosevelt Way NE
Suite B
Seattle, WA 98105-2754 - Phone
- (206) 527-2800
- Fax
- (206) 526-5394
- NPI assigned
- Jan 4, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2186 | WA | Primary |
Addresses
Primary practice location
5901 Roosevelt Way NE
Suite B
Seattle, WA 98105-2754
Mailing address
1814 NE 70TH St
Seattle, WA 98115-5754
Phone (206) 527-2856
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2186 | WA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1167868800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1750438883",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1814 NE 70TH ST",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981155754",
"telephone_number": "206-527-2856",
"fax_number": "206-527-2888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5901 ROOSEVELT WAY NE",
"address_2": "SUITE B",
"city": "SEATTLE",
"state": "WA",
"postal_code": "981052754",
"telephone_number": "206-527-2800",
"fax_number": "206-526-5394"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALLACE",
"first_name": "KATHERINE",
"middle_name": "ANN",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-04",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "WA",
"license": "2186",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Seattle, WA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.