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General NPI Number Information
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NPI Number | 1801966247
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Entity Type | Individual
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Provider Name | JENNIFER MARIE WALKER LMP
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Gender | Female
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Dates
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Enumeration Date | 11/09/2006
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Last Update Date | 09/23/2024
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Provider Practice Location Address
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Address Line | 5920 100TH ST SW STE 22
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City | LAKEWOOD
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State | WA
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Zip | 98499-2751
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Country | US
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Telephone | 253-581-1442
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Fax | 253-449-0564
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Provider Business Mailing Address
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Address Line | 1807 15TH AVE
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City | MILTON
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State | WA
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Zip | 98354-9106
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Country | US
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Telephone | 253-370-6868
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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 | 225700000X
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Taxonomy Name | Massage Therapist
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License Number | MA00019236
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License Number State | WA
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