DR. MARILYN J WALLER-NIEWOLD D.P.M. NPI 1568465177

NPI Information

NPI: 1568465177
Provider Name: DR. MARILYN J WALLER-NIEWOLD, D.P.M.
Classification: Podiatrist - 213ES0103X
Entity Type: Individual

Specialization: Foot & Ankle Surgery

Address:
1270 KOT-NUM ROAD, BOX 1209
WARM SPRINGS, OR
ZIP 98861
Phone: (541) 553-1196
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DR. Marilyn J Waller-niewold, D.P.M. is a foot and ankle surgery podiatrist in Warm Springs, OR. DR. Marilyn J Waller-niewold, D.P.M. NPI is 1568465177. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1270 KOT-NUM ROAD, BOX 1209
WARM SPRINGS, OR
ZIP 98861
Phone: (541) 553-1196
Fax: (541) 553-2613

The enumeration date for this NPI number is 5/27/2005 and was last updated on 6/14/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	213ES0103X	Podiatrist	Foot & Ankle Surgery	E3808	CALIFORNIA	No
2	213ES0103X	Podiatrist	Foot & Ankle Surgery	DP00352	OREGON	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State
1	0407825	MEDICAID	CALIFORNIA
2	U42642	MEDICARE UPIN
3	273855	MEDICAID	OREGON
4	8HE619	MEDICARE PIN	OREGON

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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