1144462375 NPI number — MS. AMBER N WALKER M. P.T.

Table of content: MS. AMBER N WALKER M. P.T. (NPI 1144462375)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144462375 NPI number — MS. AMBER N WALKER M. P.T.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WALKER
Provider First Name:
AMBER
Provider Middle Name:
N
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
M. P.T.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1144462375
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/03/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
4220 132ND ST SE
Provider Second Line Business Mailing Address:
SUITE 101
Provider Business Mailing Address City Name:
MILL CREEK
Provider Business Mailing Address State Name:
WA
Provider Business Mailing Address Postal Code:
98012-8999
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
425-357-9380
Provider Business Mailing Address Fax Number:
425-338-9637

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
919 STATE AVE
Provider Second Line Business Practice Location Address:
SUITE 101
Provider Business Practice Location Address City Name:
MARYSVILLE
Provider Business Practice Location Address State Name:
WA
Provider Business Practice Location Address Postal Code:
98270-4284
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
360-386-7405
Provider Business Practice Location Address Fax Number:
360-386-7406
Provider Enumeration Date:
04/02/2009

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 225100000X , with the licence number:  3107250 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 0328446 . This is a "L & I" identifier , issued by the state of ( WA ) . This identifiers is of the category "OTHER".




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