Provider Demographics
NPI:1093431165
Name:WALKER, CAROLYN M (COUNSELOR)
Entity Type:Individual
Prefix:
First Name:CAROLYN
Middle Name:M
Last Name:WALKER
Suffix:
Gender:F
Credentials:COUNSELOR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15730 SE 253RD PL
Mailing Address - Street 2:
Mailing Address - City:COVINGTON
Mailing Address - State:WA
Mailing Address - Zip Code:98042-4176
Mailing Address - Country:US
Mailing Address - Phone:206-999-7218
Mailing Address - Fax:
Practice Address - Street 1:2329 RAINIER AVE S
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-5302
Practice Address - Country:US
Practice Address - Phone:206-999-7218
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-10-19
Last Update Date:2022-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor