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General NPI Number Information
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NPI Number | 1225325483
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Entity Type | Individual
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Provider Name | LATOSHA K WALKER FNP-BC
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Gender | Female
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Dates
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Enumeration Date | 07/07/2011
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Last Update Date | 05/31/2023
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Provider Practice Location Address
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Address Line | 1400 112TH AVE SE STE 100
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City | BELLEVUE
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State | WA
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Zip | 98004-6901
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Country | US
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Telephone | 425-891-0104
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Fax |
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Provider Business Mailing Address
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Address Line | 1400 112TH AVE SE STE 100
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City | BELLEVUE
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State | WA
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Zip | 98004-6901
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Country | US
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Telephone | 425-891-0104
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP2300X
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Taxonomy Name | Primary Care Nurse Practitioner
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License Number | 14991
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | AP61377971
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License Number State | WA
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