Individual
WALTER LEROY WILLIAMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1433 5TH ST, CLARKSTON, WA 99403-2714
(509) 758-5141
(509) 758-5299
Mailing address
4700 EXCHANGE CT STE 110, BOCA RATON, FL 33431-4450
(561) 948-0291
(561) 859-0429
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
MD.MD.00041565
WA
174400000X
Specialist
MD00041565
WA
207N00000X
Dermatology Physician
Primary
MD.MD.00041565
WA
207N00000X
Dermatology Physician
Primary
MD00041565
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000010139009
REGENCE BLUE SHIELD PROV.
ID
01
—
030734610
PREMERA BLUE CROSS #
WA
01
—
1117878
WASHINGTON MEDICAID #
WA
01
—
72157
BLUE CROSS OF IDAHO
ID
05
—
806377300
—
ID
01
—
MD00041565
WASHINGTON LICENSE
WA
01
—
P00007739
RAILROAD MEDICARE #
WA
Enumeration date
03/16/2006
Last updated
08/04/2026
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