Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207K00000X | Allergist & Immunologist | MD00040997 | WA |
NPI | 1215964671 |
---|---|
Provider Name | John C Walker |
First Address | Seatte, WA 98115-2514 |
Second Address | Richland, WA 99352-4387 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/06/2006 |
Last Update Date | 03/09/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
8151WA | REGENCE (01) | WA |
8322059 | (05) | WA |
H73506 | (02) | WA |