Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mr. Gordon Jay Wallis, LMT

Individual provider Specialist · NPI 1548711005

Mr. Gordon Jay Wallis, LMT is a Specialist in Anchorage, Alaska. Practices as a sole proprietor. Licensed in Alaska.

Licensed in
AK
In the registry since
2016
What do these letters mean?
LMT — Licensed Massage Therapist
A state-licensed massage therapist.

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Practice location Address checks out

142 W 5th Ave
Anchorage, AK 99501-2522
Phone: (907) 258-1122
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Specialist (primary) Taxonomy 174400000X · Licence 101469 (AK)

Record details

NPI number1548711005
Entity typeIndividual (Type 1)
GenderMale
Credentials LMT
Sole proprietorYes
NPI enumeratedOctober 19, 2016
Last updated in NPPESOctober 19, 2016
Mailing address1020 W 12th Ave, Suite 714, Anchorage, AK 99501-4577

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