MR. GORDON JAY WALLIS LMT.
NPI 1548711005
Specialist in Anchorage, AK

Q: What is Gordon Wallis's NPI number?

The NPI number for Gordon Wallis is 1548711005. It was assigned to this individual provider in the NPPES registry on October 19, 2016.

Q: What is Gordon Wallis's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

Q: When was this NPI record last updated?

The NPPES record for Gordon Wallis was last updated on October 19, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 19, 2016

142 W 5TH AVE, ANCHORAGE, AK 99501(907) 258-1122 Get Directions Write a Review

NPPES record last updated: October 19, 2016. Verified against the NPPES registry weekly; last sync: August 16, 2026.

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About Mr. Gordon Jay Wallis Lmt. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. GORDON JAY WALLIS LMT. (NPI 1548711005) is an individual specialist in Anchorage, Alaska, licensed in Alaska (101469) and active in the NPI registry since October 2016.

NPPES Registry Identity

NPI1548711005

Entity TypeIndividualMale

Primary Taxonomy174400000X

Provider Legal NameMR. GORDON JAY WALLISCredential: LMT.

Location Address142 W 5TH AVEAnchorage, AK 99501-2522

Mailing Address1020 W 12th Ave, Suite 714Anchorage, AK 99501-4577 · (907) 602-9045

Phone(907) 258-1122

Sole ProprietorYes

Enumeration DateOctober 19, 2016

✔ NPI 1548711005 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers

Taxonomy Code174400000X

License✔ Licensed in AK · 101469

Definition

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.

142 W 5TH AVE, Anchorage, AK 99501

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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Gordon Wallis's NPI number?

The NPI number for Gordon Wallis is 1548711005. It was assigned to this individual provider in the NPPES registry on October 19, 2016.

Where is Gordon Wallis located?

Gordon Wallis practices at 142 W 5th Ave, Anchorage, AK 99501. The listed phone number is (907) 258-1122.

What is Gordon Wallis's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Gordon Wallis was last updated on October 19, 2016. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.