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NPI Code Detail

MEDICARE: KATHLEEN PATRICIA WALTER MSW, LSWAA

MEDICARE:   KATHLEEN PATRICIA WALTER  MSW, LSWAA
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
11041C0700XClinical Social WorkerSA60352584WA
2104100000XSocial WorkerSA60352584WA

General Provider Information

NPI Number : 1851661912
Entity Type Code : Individual
Provider Name (Legal Business Name) : KATHLEEN PATRICIA WALTER MSW, LSWAA
Provider Business Mailing Address
First Line : 515 116TH AVE NE
Second Line : OLIVE CREST
City : BELLEVUE
State : WA
Zip : 98004-5223
Country : US
Telephone Number : 425-462-1612
Fax Number : 425-462-9268
Provider Business Practice Location Address
First Line : 515 116TH AVE NE
Second Line : OLIVE CREST
City : BELLEVUE
State : WA
Zip : 98004-5223
Country : US
Telephone Number : 425-462-1612
Fax Number : 425-462-9268
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2012
Last Update Date : 07/10/2013

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Directions to “ KATHLEEN PATRICIA WALTER MSW, LSWAA” Practice Location

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