Provider Demographics
NPI:1376826040
Name:WALKER, ANDREW JAKE (PHARMD)
Entity Type:Individual
Prefix:
First Name:ANDREW
Middle Name:JAKE
Last Name:WALKER
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1820 N 45TH ST
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98103-6803
Mailing Address - Country:US
Mailing Address - Phone:206-632-3314
Mailing Address - Fax:206-545-8154
Practice Address - Street 1:1820 N 45TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98103-6803
Practice Address - Country:US
Practice Address - Phone:206-632-3314
Practice Address - Fax:206-545-8154
Is Sole Proprietor?:No
Enumeration Date:2011-09-20
Last Update Date:2014-01-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60163773183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist