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General NPI Number Information
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NPI Number | 1851661912
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Entity Type | Individual
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Provider Name | KATHLEEN PATRICIA WALTER MSW, LSWAA
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Gender | Female
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Dates
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Enumeration Date | 01/06/2012
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Last Update Date | 07/10/2013
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Provider Practice Location Address
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Address Line | 515 116TH AVE NE OLIVE CREST
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City | BELLEVUE
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State | WA
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Zip | 98004-5223
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Country | US
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Telephone | 425-462-1612
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Fax | 425-462-9268
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Provider Business Mailing Address
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Address Line | 515 116TH AVE NE OLIVE CREST
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City | BELLEVUE
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State | WA
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Zip | 98004-5223
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Country | US
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Telephone | 425-462-1612
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Fax | 425-462-9268
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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 | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | SA60352584
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License Number State | WA
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Taxonomy #2
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | SA60352584
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License Number State | WA
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