Healthcare Provider Details

I. General information

NPI: 1922920693
Provider Name (Legal Business Name): KATRINA WALKER RDH
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/27/2026
Last Update Date: 09/03/2026
Certification Date: 09/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

800 KENSINGTON AVE STE 204
MISSOULA MT
59801-5670
US

IV. Provider business mailing address

800 KENSINGTON AVE STE 204
MISSOULA MT
59801-5670
US

V. Phone/Fax

Practice location:
  • Phone: 406-550-3795
  • Fax:
Mailing address:
  • Phone: 406-550-3795
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number1252
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: