Individual
JEREMY KEITH WALKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
RRT
Contact information
Practice address
1401 N 10TH AVE, STAYTON, OR 97383-1311
(503) 769-2175
Mailing address
2745 SE 167TH AVE, PORTLAND, OR 97236-1405
(971) 719-9524
Taxonomy
Speciality
Code
Description
License number
State
227900000X
Registered Respiratory Therapist
Primary
RT-P-10176185
OR
Other
Enumeration date
02/13/2020
Last updated
02/13/2020
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