Provider Demographics
NPI:1619959152
Name:WALKER, DAVID LEWIS (MD)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:LEWIS
Last Name:WALKER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 120TH AVE NE STE 204
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:WA
Mailing Address - Zip Code:98005-2138
Mailing Address - Country:US
Mailing Address - Phone:425-283-4200
Mailing Address - Fax:425-679-5679
Practice Address - Street 1:1215 120TH AVE NE STE 204
Practice Address - Street 2:
Practice Address - City:BELLEVUE
Practice Address - State:WA
Practice Address - Zip Code:98005-2138
Practice Address - Country:US
Practice Address - Phone:425-283-4200
Practice Address - Fax:425-679-5679
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2013-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMD00027763207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA119936OtherLABOR & INDUSTRIES
WA8122574Medicaid
080124611OtherMEDICARE RAILROAD
WA1822WAOtherBLUE SHIELD
WAG8864800Medicare PIN
WAGAB03186Medicare PIN
080124611OtherMEDICARE RAILROAD
WA119936OtherLABOR & INDUSTRIES
WA8122574Medicaid