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Contact Information

JENNIFER M WALLER, LAT, ATC
14575 NE 35TH STREET E104
BELLEVUE, WA98007
 Phone: 704-962-5557
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Athletic Trainer

2255A2300X
Indicates primary specialty

NPI Profile & details for JENNIFER M WALLER · (Female)

NPI Number 1942645965
Status Active
Credentials LAT, ATC
Entity Individual
Enumeration date 05/03/2013
Last updated 05/03/2013 - About 13 years ago
Sole proprietor 1 No
Identifiers
  • WA License # A1 60329486
  • WA Other 22 RESPIRATORY, REHABILITATIVE & RESTORATIVE SERVICE PROVIDERS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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