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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

MR. GORDON JAY WALLIS, LMT.

Active Sole Proprietor

Specialist · ANCHORAGE, AK

Registration Details

NPI Number
1548711005
Provider Type
Individual
Gender
Male
NPI Issued
Oct 19, 2016 (9.5255546270732 yrs)
Last Updated
Oct 19, 2016
License
101469 (AK)
Sole Proprietor
Yes

Practice Information

Address
142 W 5TH AVE
ANCHORAGE, AK, 995012522
Browse AK providers · Browse ZIP 99501
Phone
9072581122
Primary Specialty
Specialist
174400000X

Other Specialist Providers in ANCHORAGE, AK

Name Credential NPI
CAROLYN RHENE MERKOURIS MD 1174503395
MICHELE O'FALLON M.D. 1902877251
LAURIE MONTANO M.D. 1710958061
DR. LATHA SUBRAMANIAN M.D. 1841262201
MARY C TOTTEN MD 1487602066
DR. JEANNE E. ANDERSON MD 1851334346
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.