GWEN G. WALLICK (NPI# 1295961720) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1295961720 |
| Entity Type | Individual |
| Full Name | GWEN G. WALLICK |
| Credential | LMT, LMP |
| Practice Address |
13731 231st Ln Ne Redmond WA 98053-5697 |
| Practice Telephone | 5414305282 |
| Mailing Telephone | 5414305282 |
| Enumeration Date | 2009-06-10 |
| Last Update Date | 2009-06-10 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 225700000X | Massage Therapist | 14303 | OR | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Y | 225700000X | Massage Therapist | MA60085483 | WA | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
13731 231ST LN NE |
| City | REDMOND |
| State | WA |
| Zip Code | 98053-5697 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154830669 | Sharon Ann Amaral | Acupuncturist | 8700 196th Ave Ne, Redmond, WA 98053 | 2017-09-27 |
| 1467877670 | John Paul Lytle Jr. | Radiology | 6729 204th Dr. Ne, Redmond, WA 98053 | 2014-02-25 |
| 1649606906 | Mitchell Allen Luce | Physical Therapist | 4719 272nd Ave Ne, Redmond, WA 98053 | 2013-09-18 |
| 1275825671 | Jennifer Vanessa Munson | Massage Therapist | 23515 Northeast Novelty Hill Road, #225, Redmond, WA 98053 | 2011-05-04 |
| 1245495084 | Jessica Lee Morrow | Massage Therapist | 23525 N.e. Novelty Hill Rd., Redmond Ridge Chiropractic, Redmond, WA 98053 | 2008-07-22 |
| 1194835553 | Rebecca C Lavin | Massage Therapist | 10733 221st Ln Ne Ste A, Redmond, WA 98053 | 2006-08-30 |
| 1033178702 | Michael Fine | Specialist/Technologist | 20301 Ne 108th Street, Redmond, WA 98053 | 2006-03-21 |
| 1104804277 | Jennifer A Martyn | Physical Therapist | 7711 196th Ave Ne, Redmond, WA 98053 | 2006-01-09 |
| 1508359183 | Shannon Vaadeland | Physical Therapist | 22500 Ne Marketplace Dr Ste 204, Redmond, WA 98053 | 2018-06-08 |
| 1932274248 | Julie Wen | Pediatrics | 22635 Market Place Drive, Suite #120, Redmond, WA 98053 | 2006-11-21 |
| Find all providers in zip 98053 | ||||
| Taxonomy Code | 225700000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Massage Therapist |
| An individual trained in the manipulation of tissues (as by rubbing, stroking, kneading, or tapping) with the hand or an instrument for remedial or hygienic purposes. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699387126 | Britney Ann Carreon | Massage Therapist | 1397 Nw 6th St Bldg 19a, Redmond, OR 97756-1433 | 2020-08-17 |
| 1639700164 | Vivian Heather May | Massage Therapist | 8610 164th Ave Ne Apt 19, Redmond, WA 98052-3640 | 2020-02-03 |
| 1548819923 | Octavian Natural Health Pllc | Massage Therapist | 16450 Redmond Way Unit 125, Redmond, WA 98052-2479 | 2019-09-08 |
| 1740740612 | Jeanelle Parrott | Massage Therapist | 22635 Ne Marketplace Dr Ste 130, Redmond, WA 98053-5885 | 2019-03-25 |
| 1487124251 | Brittney Lynn Zook | Massage Therapist | 249 Nw 27th Ct, Redmond, OR 97756-7215 | 2018-12-04 |
| 1598233108 | Aya Nakamura | Massage Therapist | 16828 Ne 79th St, Redmond, WA 98052-4424 | 2018-11-13 |
| 1033609912 | Harmony Rachel Tracy | Massage Therapist | 1680 Sw 21st St, Redmond, OR 97756-9570 | 2018-05-16 |
| 1821516014 | Ellen Crownover | Massage Therapist | 2593 Sw 27th St, Redmond, OR 97756-8125 | 2017-09-07 |
| 1225568561 | Hannah Louise Fish | Massage Therapist | 1508 Nw 8th St, Redmond, OR 97756-1102 | 2017-06-19 |
| 1043750607 | Melissa Goray | Massage Therapist | 2231 Sw 29th St, Redmond, OR 97756-8059 | 2017-03-02 |
| Find all providers in REDMOND | ||||
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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.