Provider Demographics
NPI:1093757023
Name:WALKER, DIANE E (ARNP)
Entity Type:Individual
Prefix:
First Name:DIANE
Middle Name:E
Last Name:WALKER
Suffix:
Gender:F
Credentials:ARNP
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Other - Credentials:
Mailing Address - Street 1:PO BOX 34936
Mailing Address - Street 2:DEPT # 5006
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98124-1936
Mailing Address - Country:US
Mailing Address - Phone:206-439-2988
Mailing Address - Fax:206-431-3939
Practice Address - Street 1:13030 MILITARY RD S
Practice Address - Street 2:SUITE # 210
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-3085
Practice Address - Country:US
Practice Address - Phone:206-242-6500
Practice Address - Fax:206-246-7946
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-12
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
WAAP30001360363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAS64124Medicare UPIN