Healthcare Provider Details

I. General information

NPI: 1235794629
Provider Name (Legal Business Name): CHELSEA WALKER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CHELSEA GLASGOW

II. Dates (important events)

Enumeration Date: 05/01/2019
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4600 25TH AVE NE STE 100
SALEM OR
97301-0338
US

IV. Provider business mailing address

2800 SW PEACEFUL LN
PORTLAND OR
97239-1161
US

V. Phone/Fax

Practice location:
  • Phone: 855-772-8847
  • Fax:
Mailing address:
  • Phone: 503-516-9085
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: