1699050351 NPI number — DR. WALKER JAMEY KIRKPATRICK N.D.

Table of content: DR. WALKER JAMEY KIRKPATRICK N.D. (NPI 1699050351)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1699050351 NPI number — DR. WALKER JAMEY KIRKPATRICK N.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KIRKPATRICK
Provider First Name:
WALKER
Provider Middle Name:
JAMEY
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
N.D.
Provider Gender Code:
M

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:
1699050351
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/19/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17147 S. MCCUBBIN RD.
Provider Second Line Business Mailing Address:
SUITE 218
Provider Business Mailing Address City Name:
OREGON CITY
Provider Business Mailing Address State Name:
OR
Provider Business Mailing Address Postal Code:
97045
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
805-305-4588
Provider Business Mailing Address Fax Number:
971-925-4846

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1800 BLANKENSHIP ROAD
Provider Second Line Business Practice Location Address:
SUITE 218
Provider Business Practice Location Address City Name:
WEST LINN
Provider Business Practice Location Address State Name:
OR
Provider Business Practice Location Address Postal Code:
97068
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
805-305-4588
Provider Business Practice Location Address Fax Number:
971-925-4846
Provider Enumeration Date:
10/13/2011

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: 175F00000X , with the licence number:  ND611 , registered in the state of CA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 175F00000X , with the licence number: 1840 , registered in the state of OR ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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