Provider Demographics
NPI:1215964671
Name:WALKER, JOHN C (MD)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:C
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9725 3RD. AVE NE #500
Mailing Address - Street 2:
Mailing Address - City:SEATTE
Mailing Address - State:WA
Mailing Address - Zip Code:98115-2514
Mailing Address - Country:US
Mailing Address - Phone:206-527-1200
Mailing Address - Fax:206-527-2514
Practice Address - Street 1:108 COLUMBIA POINT DR
Practice Address - Street 2:
Practice Address - City:RICHLAND
Practice Address - State:WA
Practice Address - Zip Code:99352-4387
Practice Address - Country:US
Practice Address - Phone:509-946-0189
Practice Address - Fax:509-946-0264
Is Sole Proprietor?:No
Enumeration Date:2006-06-28
Last Update Date:2019-09-03
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WAMD00040997207K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207K00000XAllopathic & Osteopathic PhysiciansAllergy & Immunology
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA8322059Medicaid
WA8151WAOtherREGENCE
WA8322059Medicaid
WA8151WAOtherREGENCE