Individual
FREDERICK CHARLES WALTERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1298 GROW AVE NW, BAINBRIDGE ISLAND, WA 98110
(206) 780-5437
(206) 780-5438
Mailing address
1298 GROW AVE NW, BAINBRIDGE ISLAND, WA 98110
(206) 780-5437
(206) 780-5438
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
MD00040201
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0039577
LABOR AND INDUSTRIES #
WA
01
—
7675WA
BLUE SHIELD #
WA
05
—
8369928
—
WA
01
—
US7740466
AETNA SPECIALIST PIN
WA
Enumeration date
01/08/2007
Last updated
06/07/2018
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