Provider Demographics
NPI:1497061337
Name:WALKER, JEFFREY L (PHARMD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:L
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 1:3333 S 120TH PL
Mailing Address - Street 2:SUITE 100
Mailing Address - City:TUKWILA
Mailing Address - State:WA
Mailing Address - Zip Code:98168-5134
Mailing Address - Country:US
Mailing Address - Phone:425-687-4426
Mailing Address - Fax:425-687-4430
Practice Address - Street 1:3333 S 120TH PL
Practice Address - Street 2:SUITE 100
Practice Address - City:TUKWILA
Practice Address - State:WA
Practice Address - Zip Code:98168-5134
Practice Address - Country:US
Practice Address - Phone:425-687-4426
Practice Address - Fax:425-687-4430
Is Sole Proprietor?:No
Enumeration Date:2010-08-30
Last Update Date:2015-12-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAPH60142970183500000X, 183500000X
CA65389183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist