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General NPI Number Information
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NPI Number | 1336601376
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Entity Type | Individual
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Provider Name | MANNING WALKER
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Gender | Male
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Dates
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Enumeration Date | 04/01/2019
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Last Update Date | 10/20/2025
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Provider Practice Location Address
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Address Line | 310 1/2 1ST ST
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City | MARYSVILLE
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State | CA
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Zip | 95901
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Country | US
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Telephone | 541-246-4201
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Fax |
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Provider Business Mailing Address
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Address Line | 1775 DAVIS RD S
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City | SALEM
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State | OR
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Zip | 97306
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Country | US
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Telephone | 541-246-4201
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Fax | 541-342-7987
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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 | 101Y00000X
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Taxonomy Name | Counselor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 146N00000X
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Taxonomy Name | Basic Emergency Medical Technician
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License Number | 140910
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License Number State | OR
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Taxonomy #3
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Taxonomy Code | 175T00000X
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Taxonomy Name | Peer Specialist
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License Number | MPSS-AEOZIG
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License Number State | CA
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