Provider Demographics
NPI:1801837406
Name:WALKER, LAUREL K (AUD)
Entity Type:Individual
Prefix:DR
First Name:LAUREL
Middle Name:K
Last Name:WALKER
Suffix:
Gender:F
Credentials:AUD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 3360
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:OR
Mailing Address - Zip Code:97208-3360
Mailing Address - Country:US
Mailing Address - Phone:866-366-2983
Mailing Address - Fax:
Practice Address - Street 1:3216 NORTON AVE
Practice Address - Street 2:SUITE 102
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-4290
Practice Address - Country:US
Practice Address - Phone:425-297-5350
Practice Address - Fax:425-297-5355
Is Sole Proprietor?:No
Enumeration Date:2006-06-08
Last Update Date:2021-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALD00001054231H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes231H00000XSpeech, Language and Hearing Service ProvidersAudiologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0212420OtherLABOR AND INDUSTRY
WAP00298188OtherRAILROAD MEDICARE
WALD00001054OtherSTATE LICENSE NUMBER
WA8457012Medicaid
WA0212420OtherLABOR AND INDUSTRY