Individual
WALTER R. FENNING
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
21601 76TH AVE W, EDMONDS, WA 98026-7507
(425) 640-4000
(206) 672-0211
Mailing address
1954 FORT UNION BLVD STE 119, SALT LAKE CITY, UT 84121-6994
(866) 910-6157
(801) 733-5623
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
MD00020794
WA
207LP2900X
Pain Medicine (Anesthesiology) Physician
MD00020794
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8543100
—
WA
Enumeration date
05/20/2006
Last updated
07/16/2007
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