Healthcare Provider Details

I. General information

NPI: 1679909006
Provider Name (Legal Business Name): CHELSEA C WALTER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/17/2013
Last Update Date: 04/27/2026
Certification Date: 04/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3001 PALM WAY STE D134
AUSTIN TX
78758-7963
US

IV. Provider business mailing address

2219 13TH AVE W APT 2
SEATTLE WA
98119-2428
US

V. Phone/Fax

Practice location:
  • Phone: 888-663-6331
  • Fax: 415-252-7176
Mailing address:
  • Phone: 402-560-5201
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA15999
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number017002
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License NumberPA60668491
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: