Ms Karen L Wallace, RD, CD is a medicare enrolled "Dietitian, Registered" provider in Mill Creek, Washington. Her current practice location is
15418 Main St, Ste 301, Mill Creek, Washington. You can reach out to her office (for appointments etc.) via phone at
(425) 385-3262.
Ms Karen L Wallace is licensed to practice in Washington (license number DI00000485) and she also participates in the medicare program. She does not accept medicare assignments directly but she may accept medicare through third-party (refer to Reassignment section below) and may also prescribe medicare part D drugs. Her NPI Number is 1760532113.
Healthcare Provider's Profile
Full Name | Ms Karen L Wallace |
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Gender | Female |
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Speciality | Dietitian, Registered |
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Location | 15418 Main St, Mill Creek, Washington |
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Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
NPI Data:
- NPI Number: 1760532113
- Provider Enumeration Date: 01/10/2007
- Last Update Date: 07/08/2007
Medicare PECOS Information:
- PECOS PAC ID: 8426956251
- Enrollment ID: I20031230000593
Medical Identifiers
Medical identifiers for Ms Karen L Wallace such as npi, medicare ID, medicare PIN, medicaid, etc.
Identifier | Type | State | Issuer |
1760532113 | NPI | - | NPPES |
Medical Taxonomies and Licenses
Taxonomy | Type | License (State) | Status |
133V00000X | Dietitian, Registered | DI00000485 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Ms Karen L Wallace is
enrolled with medicare and thus, if eligible, can prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
Mailing Address | Practice Location Address |
Ms Karen L Wallace, RD, CD 15418 Main Street, Suite 301, Mill Creek, WA 98012 Ph: (425) 385-3262 | Ms Karen L Wallace, RD, CD 15418 Main St, Ste 301, Mill Creek, WA 98012-9030 Ph: (425) 385-3262 |
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