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Active NPI 1548711005 Individual Practitioner Male Practitioner

Gordon Jay Wallis , LMT

Specialist • Anchorage, AK

Professional Overview & Biography Verified Profile Summary

Gordon Wallis, LMT is a registered healthcare professional specializing in Specialist in Anchorage, AK. Practice services are available at 142 W 5TH AVE under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

142 W 5th Ave

Anchorage, AK 995012522

Telephone 9072581122

Specialty Benchmarks & Practice Insights

Comparative analytics for Specialist in Anchorage, AK

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 31.0 Yrs
State Avg: 40.3 Yrs
Regional Practice Density
62 Specialists

Practicing in Anchorage, AK (133 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Specialist Primary Specialty

NUCC Taxonomy Code: 174400000X

State License AK 101469

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active October 19, 2016

NPI status registered as active in NPPES database

📍
Updated Practice Location October 19, 2016

Registered at 142 W 5TH AVE, ANCHORAGE, AK 995012522 (Tel: 9072581122)

📍
Updated Business Mailing Address October 19, 2016

Registered at 1020 W 12TH AVE, SUITE 714, ANCHORAGE, AK 995014577 (Tel: 9076029045)

👤
Provider Name / Credentials Updated October 19, 2016

Recorded as GORDON WALLIS, LMT.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) October 19, 2016

Specialist (License #101469 in AK)

🟢
Initial NPI Registration & Enumeration October 19, 2016

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1548711005
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: October 19, 2016
Last Update: October 19, 2016
Sole Proprietor: Yes

Mailing Address

1020 W 12th Ave, Suite 714

Anchorage, AK 995014577

Phone: 9076029045

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.