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General NPI Number Information
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NPI Number | 1568417632
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Entity Type | Individual
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Provider Name | WENDY RAE WALKER P.T.
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Gender | Female
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Dates
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Enumeration Date | 05/24/2006
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Last Update Date | 11/11/2012
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Provider Practice Location Address
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Address Line | 981 POWELL AVE SW STE 130
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City | RENTON
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State | WA
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Zip | 98057-2990
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Country | US
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Telephone | 425-228-5996
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Fax | 425-271-2310
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Provider Business Mailing Address
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Address Line | 12320 SE 167TH ST
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City | RENTON
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State | WA
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Zip | 98058-5315
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Country | US
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Telephone | 425-228-5996
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Fax | 425-271-2310
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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 | 225100000X
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Taxonomy Name | Physical Therapist
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License Number | PT00003412
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License Number State | WA
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