Healthcare Provider Details

I. General information

NPI: 1669145942
Provider Name (Legal Business Name): PENELOPE RACHELLE WALKER LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/31/2021
Last Update Date: 02/05/2025
Certification Date: 02/05/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8275 166TH AVE NE STE 200
REDMOND WA
98052-6629
US

IV. Provider business mailing address

218 MARK E REED WAY UNIT 2204
SHELTON WA
98584-5800
US

V. Phone/Fax

Practice location:
  • Phone: 425-869-2644
  • Fax: 425-867-0930
Mailing address:
  • Phone: 360-490-0585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License NumberMG61159110
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberLH61591155
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: