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NPI Code Detail

MEDICARE: KATIE WALZER

MEDICARE:   KATIE  WALZER
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1225700000XMassage Therapist26469OR

General Provider Information

NPI Number : 1053050716
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATIE WALZER
Provider Business Mailing Address
First Line : 15000 SW BARROWS RD STE 202
Second Line :
City : BEAVERTON
State : OR
Zip : 97007-8778
Country : US
Telephone Number : 925-378-8407
Fax Number :
Provider Business Practice Location Address
First Line : 15000 SW BARROWS RD STE 202
Second Line :
City : BEAVERTON
State : OR
Zip : 97007-8778
Country : US
Telephone Number : 503-489-7278
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/01/2022
Last Update Date : 06/01/2022

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Directions to “ KATIE WALZER ” Practice Location

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