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Individual

DR. KENT R WALKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
16202 64TH ST E STE 104, SUMNER, WA 98390-3028
(541) 969-3344
(253) 987-7049
Mailing address
1402 LAKE TAPPS PKWY SE, STE F104 #133, AUBURN, WA 98092
(541) 969-3344

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
OP00001577
WA
207QS0010X
Sports Medicine (Family Medicine) Physician
20295
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0432757
LABOR AND INDUSTRIES
WA
05
150117
OR
01
G9017261
MEDICARE
WA
01
P02570879
MEDICARE RR
WA
Enumeration date
07/26/2006
Last updated
02/23/2022
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