Individual
MR. LUKE M WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
2320 FREEWAY DR, MOUNT VERNON, WA 98273-5445
(360) 814-6810
(360) 814-6915
Mailing address
1400 E KINCAID ST, ATTN: CREDENTIALING, MOUNT VERNON, WA 98274-4127
(360) 428-2500
(360) 428-6485
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
OA60738463
WA
363AM0700X
Medical Physician Assistant
Primary
OA60738463
WA
Other
Enumeration date
04/20/2012
Last updated
05/03/2017
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