Individual
ALICE D WALTER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PT
Contact information
Practice address
6007 119TH AVE E, PUYALLUP, WA 98372-2830
(253) 848-9769
(253) 445-1250
Mailing address
12310 INTERLAAKEN DR SW APT L, TACOMA, WA 98498-5402
(253) 381-3431
(253) 445-1250
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
PT00000660
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0191258
DEPARTMENT OF LABOR AND INDUSTRIES
WA
Enumeration date
08/29/2006
Last updated
02/14/2012
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