Provider Demographics
NPI:1013221522
Name:WALTON, KRISTY A (MD)
Entity Type:Individual
Prefix:
First Name:KRISTY
Middle Name:A
Last Name:WALTON
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:5700 100TH ST SW STE 510
Mailing Address - Street 2:LAKEWOOD CLINIC
Mailing Address - City:LAKEWOOD
Mailing Address - State:WA
Mailing Address - Zip Code:98499-2767
Mailing Address - Country:US
Mailing Address - Phone:253-459-6060
Mailing Address - Fax:253-459-6064
Practice Address - Street 1:5700 100TH ST SW STE 510
Practice Address - Street 2:LAKEWOOD CLINIC
Practice Address - City:LAKEWOOD
Practice Address - State:WA
Practice Address - Zip Code:98499-2767
Practice Address - Country:US
Practice Address - Phone:253-459-6060
Practice Address - Fax:253-459-6064
Is Sole Proprietor?:No
Enumeration Date:2010-07-27
Last Update Date:2013-12-16
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Provider Licenses
StateLicense IDTaxonomies
WA60394984207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine