SHELLEY RENEE WALLACE (NPI# 1295030948) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295030948 |
| Entity Type | Individual |
| Full Name | SHELLEY RENEE WALLACE |
| Credential | MPH, RD, CN |
| Practice Address |
2209 E 32nd St Tacoma WA 98404-4922 |
| Practice Telephone | 2535930232 |
| Practice Fax Number | 2533822094 |
| Mailing Telephone | 2535930232 |
| Mailing Fax Number | 2533822094 |
| Enumeration Date | 2011-01-11 |
| Last Update Date | 2011-01-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 133N00000X | Nutritionist | NU 60064646 | WA | Dietary & Nutritional Service Providers |
| Y | 133V00000X | Dietitian, Registered | 00881196 | WA | Dietary & Nutritional Service Providers |
| Street Address |
2209 E 32ND ST |
| City | TACOMA |
| State | WA |
| Zip Code | 98404-4922 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255378782 | Puyallup Tribal Health Authority | Clinic/Center | 2209 E 32nd St, Tacoma, WA 98404 | 2006-06-01 |
| 1063038206 | Laura Christine Fox | Family Medicine | 2209 E 32nd St, Tacoma, WA 98404-4922 | 2020-06-23 |
| 1538783618 | Yuina Satoh | Family Medicine | 2209 E 32nd St, Tacoma, WA 98404-4922 | 2020-06-03 |
| 1144882879 | Theodore C Weatherwax | Family Medicine | 2209 E 32nd St, Tacoma, WA 98404-4922 | 2019-07-02 |
| 1497315592 | Daniel Joseph O'bryan | Family Medicine | 2209 E 32nd St, Tacoma, WA 98404-4922 | 2019-06-19 |
| 1922664424 | Arielle Jacob | Family Medicine | 2209 E 32nd St, Tacoma, WA 98404-4922 | 2019-05-10 |
| 1154987683 | Nicholas Snow | Family Medicine | 2209 E 32nd St, Tacoma, WA 98404-4922 | 2019-05-09 |
| 1063900280 | Hilary Ann Baer | Family Medicine | 2209 E 32nd St, Tacoma, WA 98404 | 2018-04-24 |
| 1659868131 | Andrew Ma | Family Medicine | 2209 E 32nd St, Tacoma, WA 98404-4922 | 2018-04-19 |
| 1184111817 | Megan S. Aspelund | Family Medicine | 2209 E 32nd St, Tacoma, WA 98404 | 2018-04-18 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386169829 | Brianna Lee Brown | Nurse's Aide | 1020 South 76th Street, Tacoma, WA 98404 | 2017-08-05 |
| 1770981045 | Tra My Thi Nguyen | Pharmacist | 4614 E N St, Tacoma, WA 98404 | 2014-12-18 |
| 1720419161 | Amber Gilderoy | Massage Therapist | 1101 E 56th St, Tacoma, WA 98404 | 2013-12-11 |
| 1295083756 | Stacy Marie Klontz | Physical Therapy Assistant | 1649 East 72nd St., Tacoma, WA 98404 | 2012-08-15 |
| 1215239892 | Kimberly Ida Sterling | Dental Hygienist | 247 E. 68th St., Tacoma, WA 98404 | 2010-12-02 |
| 1982923926 | Emily C Parry | Occupational Therapy Assistant | 1649 East 72nd Street, Tacoma, WA 98404 | 2010-05-28 |
| 1427386465 | Carole Lynne Hopkins | Physical Therapist | 1649 East 72nd St, Tacoma, WA 98404 | 2009-12-03 |
| 1417016056 | Jennifer Anne Decoteau | Social Worker | 2209 East 32nd St, Tacoma, WA 98404 | 2006-12-08 |
| 1518032374 | Agnes Barbara Kocsis | Psychiatry & Neurology | 2209 E.32nd Str, Tacoma, WA 98404 | 2006-11-21 |
| 1912924366 | Marthe Butzen | Physician Assistant | 1708 E. 44th Street, Tacoma, WA 98404 | 2006-07-15 |
| Find all providers in zip 98404 | ||||
| Taxonomy Code | 133V00000X |
| Grouping | Dietary & Nutritional Service Providers |
| Classification | Dietitian, Registered |
| A registered dietician (RD) is a food and nutrition expert who has successfully completed a minimum of a bachelor’s degree at a US regionally accredited university or college and course work approved by The American Dietetic Association (ADA); an ADA-accredited or approved, supervised practice program, typically 6 to 12 months in length; a national examination administered by the Commission on Dietetic Registration; and continuing professional educational requirements to maintain registration. |
| Notes: Source: The American Dietetic Association. Becoming a Registered Dietitian – a food and nutrition expert. Chicago, IL: The American Dietetic Association, July 1997. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1518586007 | Paige Worley | Dietitian, Registered | 3905 N 36th St, Tacoma, WA 98407-5634 | 2020-04-14 |
| 1659933554 | Julia Budniak | Dietitian, Registered | 9040 Jackson Street, Tacoma, WA 98431-0001 | 2019-07-01 |
| 1740755636 | Erika Mary Clough | Dietitian, Registered | 3401 S 19th St Ste 100, Tacoma, WA 98405-1909 | 2018-10-08 |
| 1417422577 | Paul Holthaus | Dietitian, Registered | 9040 Jackson Ave Nutrition Clinic, Tacoma, WA 98431-0001 | 2018-10-04 |
| 1003320078 | Christina Stapke | Dietitian, Registered | 1624 South I St. Ste 205, Tacoma, WA 98405 | 2017-11-28 |
| 1023530227 | Alexandra Alyse Mckee | Dietitian, Registered | 233 St Helens Ave Apt 403, Tacoma, WA 98402-2585 | 2017-07-10 |
| 1407386287 | Amber E Lagerwey | Dietitian, Registered | 15703 Pacific Ave S Ste B, Tacoma, WA 98444-4675 | 2017-06-14 |
| 1578011425 | Kyleigh Harlow | Dietitian, Registered | 11011 Park Ave S, C212, Tacoma, WA 98444 | 2016-09-20 |
| 1528439718 | Hannah Lima | Dietitian, Registered | 12615 26th Ave E, Tacoma, WA 98445-5014 | 2015-10-13 |
| 1871907519 | Anne B Corley | Dietitian, Registered | 2102 N Pearl St Ste 405, Tacoma, WA 98406-2550 | 2014-06-19 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.