DR. DAVID WALLER (NPI# 1881716603) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1881716603 |
| Entity Type | Individual |
| Full Name | DR. DAVID WALLER |
| Credential | PH.D. |
| Practice Address |
105 M St Ne Auburn WA 98002-4430 |
| Practice Telephone | 2533343905 |
| Practice Fax Number | 2538877630 |
| Mailing Telephone | 2533343905 |
| Mailing Fax Number | 2538877630 |
| Enumeration Date | 2007-04-04 |
| Last Update Date | 2013-07-08 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 103TC0700X |
Psychologist Specialization: Clinical |
764 INACTIVE STA | OR | Behavioral Health & Social Service Providers |
| Y | 103TC0700X |
Psychologist Specialization: Clinical |
PY2249 | WA | Behavioral Health & Social Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FED. EMPLOYER ID. NUMBER | 930995531 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023195781 | David M. Waller | Chiropractor | 2455 Ridge Rd, Ste. 147, Rockwall, TX 75087-5529 | 2006-11-01 |
| 1518966688 | David F Waller | Family Medicine | 4868 Bridge Rd, Suite 300, Suffolk, VA 23435-2048 | 2005-07-20 |
| 1023242286 | David Louis Waller Jr. | Physician Assistant | 60 Township Line Rd, Elkins Park, PA 19027-2220 | 2009-05-03 |
| 1588728471 | David A Waller | Psychiatry & Neurology | 5323 Harry Hines Blvd, Dallas, TX 75390-7208 | 2006-12-22 |
| Street Address |
105 M ST NE |
| City | AUBURN |
| State | WA |
| Zip Code | 98002-4430 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750701413 | Tanya Michelle Nowak | Counselor | 105 M St Ne, Auburn, WA 98002-4430 | 2014-04-22 |
| 1962831735 | The Lois Renfro Foundation | Early Intervention Provider Agency | 105 M St Ne, Auburn, WA 98002-4430 | 2013-11-02 |
| 1972783611 | Carley Jean Martinez | Counselor | 105 M St Ne, Nature To Nurture, Auburn, WA 98002-4430 | 2007-11-09 |
| 1356520209 | Matt C Milstead | Counselor | 105 M St Ne, Auburn, WA 98002-4430 | 2007-10-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1336756451 | Natalia Marquez Avalos | Interpreter | 1001 37th St Se, Apt 2, Auburn, WA 98002 | 2020-09-24 |
| 1871065607 | Carrie Ann Sasser | Registered Nurse | 1005 37th Street Se, Auburn, WA 98002 | 2018-12-18 |
| 1730658881 | Nataliya Guga | Physical Therapy Assistant | 1323 17th St Se Apt A, Auburn, WA 98002 | 2018-11-19 |
| 1952876294 | Modeline Jules | Nurse Practitioner | 125 3rd St Ne Ste 403, Auburn, WA 98002 | 2018-10-12 |
| 1679055941 | Stephanie Storm Lariccia | Social Worker | 1000 Auburn Way S., Auburn, WA 98002 | 2018-09-04 |
| 1104330349 | North Auburn Health, LLC | Skilled Nursing Facility | 2830 I Street Ne, Auburn, WA 98002 | 2017-11-27 |
| 1265950554 | Allison Ortwein | Occupational Therapist | 2830 I St. Ne, Auburn, WA 98002 | 2017-09-06 |
| 1184171167 | Emily Faber | Counselor | 505 29th St, Auburn, WA 98002 | 2016-09-07 |
| 1255887907 | Elaine Priscilla Lucas | Counselor | 29th St Se Chartley House, 505, Auburn, WA 98002 | 2016-08-31 |
| 1871955823 | Melissa Mae Gustafson | Massage Therapist | 4220 A. St. Se, Suite 103, Auburn, WA 98002 | 2016-03-28 |
| Find all providers in zip 98002 | ||||
| Taxonomy Code | 103TC0700X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | Clinical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922539543 | Nadia Bhuiyan | Psychologist | 101 Cary Hall, Auburn University, Auburn, AL 36849 | 2017-03-24 |
| 1073904231 | Bunny Stanfield | Psychologist | 6435 Fairway Ct., Auburn, CA 95602 | 2015-02-10 |
| 1689097842 | Sierra Hills Individual & Family Therapy | Psychologist | 1230 High St Ste 211, Auburn, CA 95603-5044 | 2014-01-23 |
| 1023354990 | Jennings B. Haynes | Psychologist | 2431 E Glenn Ave Ste 400, Auburn, AL 36830-6419 | 2012-12-21 |
| 1942567136 | Monique Ann Vorous | Psychologist | 381-a Nevada Street, Auburn, CA 95603 | 2012-04-12 |
| 1215249339 | Jennifer Gillis Mattson | Psychologist | 1897 Quail Holw, Auburn, AL 36830-2544 | 2010-07-06 |
| 1316181811 | Richard Edward Mattson | Psychologist | 226 Thach Ave, Thach Hall, Auburn, AL 36849-0001 | 2009-04-28 |
| 1255573267 | Christopher John Correia | Psychologist | 226 Thach Hl, Auburn University Department of Psychology, Auburn, AL 36849-0001 | 2009-04-06 |
| 1447372909 | Kristen Maria O'shea | Psychologist | 160 Cherry Ave, Auburn, CA 95603-4812 | 2007-04-04 |
| 1508907858 | Stephen Frederick Coleman | Psychologist | 11 Seminary Street, Auburn, NY 13021 | 2007-02-09 |
| Find all providers in AUBURN | ||||
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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.