Provider Demographics
NPI:1033347430
Name:WALKER, JEANETTE (MD)
Entity Type:Individual
Prefix:
First Name:JEANETTE
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:JEANETTE
Other - Middle Name:
Other - Last Name:MONSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5560 WITZEL RD SE
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97317-9142
Mailing Address - Country:US
Mailing Address - Phone:503-581-8251
Mailing Address - Fax:866-372-4073
Practice Address - Street 1:5560 WITZEL RD SE
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:OR
Practice Address - Zip Code:97317-9142
Practice Address - Country:US
Practice Address - Phone:503-581-8251
Practice Address - Fax:866-372-4073
Is Sole Proprietor?:No
Enumeration Date:2009-06-24
Last Update Date:2018-05-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORMD161788207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine