Healthcare Provider Details

I. General information

NPI: 1598323354
Provider Name (Legal Business Name): CAROLINE STEWART WALKER RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2019
Last Update Date: 04/12/2023
Certification Date: 04/12/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1536 N 115TH ST STE 130
SEATTLE WA
98133-8416
US

IV. Provider business mailing address

3920 NE 110TH ST
SEATTLE WA
98125-5737
US

V. Phone/Fax

Practice location:
  • Phone: 206-598-3344
  • Fax: 206-598-1250
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License NumberAP61059001
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN00155539
License Number StateWA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: