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Individual

DR. JONATHAN JAY WALKER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
1051 COLUMBIA AVE, CONNELL, WA 99326-8702
(509) 488-5256
(509) 488-9939
Mailing address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(509) 488-9939

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
OD60902790
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2111427
WA
Enumeration date
06/24/2015
Last updated
03/24/2021
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