Provider Demographics
NPI:1902818057
Name:WALKER, THOMAS FRANKLIN (AT EMT)
Entity Type:Individual
Prefix:
First Name:THOMAS
Middle Name:FRANKLIN
Last Name:WALKER
Suffix:
Gender:M
Credentials:AT EMT
Other - Prefix:
Other - First Name:TOM
Other - Middle Name:F
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:AT EMT
Mailing Address - Street 1:1101 HOQUIAM AVE NE
Mailing Address - Street 2:
Mailing Address - City:RENTON
Mailing Address - State:WA
Mailing Address - Zip Code:98059-4314
Mailing Address - Country:US
Mailing Address - Phone:425-204-4339
Mailing Address - Fax:425-204-4279
Practice Address - Street 1:1101 HOQUIAM AVE NE
Practice Address - Street 2:
Practice Address - City:RENTON
Practice Address - State:WA
Practice Address - Zip Code:98059-4314
Practice Address - Country:US
Practice Address - Phone:425-204-4339
Practice Address - Fax:425-204-4279
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-13
Last Update Date:2014-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAA1600473292255A2300X
WA0101189146N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer
No146N00000XEmergency Medical Service ProvidersEmergency Medical Technician, Basic