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General NPI Number Information
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NPI Number | 1306077896
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Entity Type | Individual
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Provider Name | JONATHAN REECE WALKER MA
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Gender | Male
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Dates
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Enumeration Date | 07/31/2009
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Last Update Date | 10/28/2011
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Provider Practice Location Address
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Address Line | 10202 SE 32ND AVE 504
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City | MILWAUKIE
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State | OR
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Zip | 97222-3610
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Country | US
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Telephone | 503-496-1190
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Fax | 503-496-1195
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Provider Business Mailing Address
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Address Line | 10202 SE 32ND AVE 504
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City | MILWAUKIE
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State | OR
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Zip | 97222-3610
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Country | US
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Telephone | 503-496-1190
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Fax | 503-496-1195
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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