Healthcare Provider Details

I. General information

NPI: 1801837406
Provider Name (Legal Business Name): LAUREL K WALKER AU.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/08/2006
Last Update Date: 04/28/2021
Certification Date: 04/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3216 NORTON AVE SUITE 102
EVERETT WA
98201-4290
US

IV. Provider business mailing address

PO BOX 3360
PORTLAND OR
97208-3360
US

V. Phone/Fax

Practice location:
  • Phone: 425-297-5350
  • Fax: 425-297-5355
Mailing address:
  • Phone: 866-366-2983
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code231H00000X
TaxonomyAudiologist
License NumberLD00001054
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: