JOANNE M WALLIS PNP NPI 1932370756

NPI Information

NPI: 1932370756
Provider Name: JOANNE M WALLIS, PNP
Classification: Nurse Practitioner - 363LP2300X
Entity Type: Individual

Specialization: Primary Care

Organization: SEA-MAR COMMUNITY HEALTH CENTER

PECOS Registration: Yes

Address:
19005 SE 34TH ST
VANCOUVER, WA
ZIP 98683
Phone: (360) 726-6724
Get Directions

Joanne M Wallis, PNP is a primary care nurse practitioner in Vancouver, WA with 27 years of experience. Joanne M Wallis, PNP NPI is 1932370756. 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:

19005 SE 34TH ST
VANCOUVER, WA
ZIP 98683-450
Phone: (360) 726-6724
Fax: (360) 726-6718

The NPI 1932370756 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 3/19/2008 and was last updated on 3/17/2018.

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	363LP0200X	Nurse Practitioner	Pediatrics	091000332N2-PNP-PP	OREGON	No
2	363LP2300X	Nurse Practitioner	Primary Care	AP30006123	WASHINGTON	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	Other Provider Identifier Issuer
1	22959	MEDICAID	OREGON
2	022959	MEDICAID	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: 11/14/2023

NPI Synchronization or Removal

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