Provider Demographics
NPI:1871666081
Name:WALKER, WILLOW E (RN)
Entity Type:Individual
Prefix:
First Name:WILLOW
Middle Name:E
Last Name:WALKER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2051 KAEN RD
Mailing Address - Street 2:SUITE 367
Mailing Address - City:OREGON CITY
Mailing Address - State:OR
Mailing Address - Zip Code:97045-4035
Mailing Address - Country:US
Mailing Address - Phone:503-742-5300
Mailing Address - Fax:503-655-8350
Practice Address - Street 1:2051 KAEN RD
Practice Address - Street 2:SUITE 367
Practice Address - City:OREGON CITY
Practice Address - State:OR
Practice Address - Zip Code:97045-4035
Practice Address - Country:US
Practice Address - Phone:503-742-5300
Practice Address - Fax:503-655-8350
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
OR163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered171M00000XOther Service ProvidersCase Manager/Care Coordinator
Not Answered163W00000XNursing Service ProvidersRegistered Nurse