Healthcare Provider Details
I. General information
NPI: 1659192656
Provider Name (Legal Business Name): WALKER & WALKER LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 10/22/2024
Last Update Date: 10/22/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1551 NE 4TH ST
BEND OR
97701-4241
US
IV. Provider business mailing address
1551 NE 4TH ST
BEND OR
97701-4241
US
V. Phone/Fax
- Phone: 541-389-9373
- Fax:
- Phone: 541-389-9373
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 111N00000X |
| Taxonomy | Chiropractor |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
TRAVIS
WALKER
Title or Position: CEO / DOCTOR
Credential: DC
Phone: 503-708-0387