Individual
JACKIE WALKER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LM, CPM
Contact information
Practice address
1417 NE TALBOTT DR, GRANTS PASS, OR 97526-3544
(805) 610-3943
Mailing address
1417 NE TALBOTT DR, GRANTS PASS, OR 97526-3544
(805) 610-3943
Taxonomy
Speciality
Code
Description
License number
State
174N00000X
Lactation Consultant (Non-RN)
10248671
OR
176B00000X
Midwife
Primary
421
CA
374J00000X
Doula
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10183250
OREGON HEALTH AUTHORITY LICENSE
OR
01
—
421
CALIFORNIA MEDICAL BOARD
CA
Enumeration date
01/20/2015
Last updated
12/29/2025
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