Provider Demographics
NPI:1851846307
Name:WALKER & HENRY PS
Entity Type:Organization
Organization Name:WALKER & HENRY PS
Other - Org Name:WALKER FAMILY DENTAL
Other - Org Type:Doing Business As
Authorized Official - Title/Position:GENERAL MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:DARILYN
Authorized Official - Middle Name:
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:253-848-3553
Mailing Address - Street 1:2802 S MERIDIAN
Mailing Address - Street 2:
Mailing Address - City:PUYALLUP
Mailing Address - State:WA
Mailing Address - Zip Code:98373-1402
Mailing Address - Country:US
Mailing Address - Phone:253-848-3553
Mailing Address - Fax:253-848-3702
Practice Address - Street 1:2802 S MERIDIAN
Practice Address - Street 2:
Practice Address - City:PUYALLUP
Practice Address - State:WA
Practice Address - Zip Code:98373-1402
Practice Address - Country:US
Practice Address - Phone:253-848-3553
Practice Address - Fax:253-848-3702
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-08-24
Last Update Date:2016-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE60098395122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty