Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 103TB0200X | Cognitive & Behavioral Psychologist | 1888 | OR |
N | 103G00000X | Clinical Psychologist | 1888 | OR |
N | 103TC0700X | Clinical Psychologist | 1888 | OR |
Y | 103TF0200X | Forensic Psychologist | 1888 | OR |
NPI | 1023256013 |
---|---|
Provider Name | Dr. Darci Leigh Walker |
First Address | Portland, OR 97205-2234 |
Second Address | Portland, OR 97205-2234 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 28/01/2009 |
Last Update Date | 08/09/2010 |