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Gordon Jay Wallis, LMT.

NPI 1548711005ActiveIndividual· Specialist· Anchorage, AK

Specialist (LMT.) in Anchorage, Alaska, licensed in AK, with an NPI issued in October 2016.

Overview

NPI1548711005
StatusActive
Entity typeIndividual
CredentialLMT.
Sole proprietorYes
NPI issuedOct 19, 2016
Last updated in NPPESOct 19, 2016

Specialties and licenses

TaxonomyCodeLicenseState
Specialist Primary174400000X101469AK

About license numbers in NPPES

Exclusion screening

ListResultDetails
HHS-OIG LEIE · Nov 10, 2026No matchChecked by NPI and by name + state
North Carolina Medicaid · Nov 11, 2026No match—
New York OMIG · Nov 11, 2026No match—
Ohio Medicaid · Nov 11, 2026No match—
Pennsylvania Medicheck · Nov 11, 2026No match—
Washington HCA · Nov 11, 2026No match—

Official OIG search · How matching works ·Bulk check a roster

Medicare

Enrollment (PECOS)Not in the public enrollment file of Oct 1, 2026

Medicare sources and data years

Other Specialist providers in Anchorage

All 81 Specialist providers in Anchorage · All Specialist providers in Alaska