Provider Demographics
NPI:1942050554
Name:WALKER, GABRIEL BRYANT
Entity Type:Individual
Prefix:MR
First Name:GABRIEL
Middle Name:BRYANT
Last Name:WALKER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3661 SW VOLCANO AVE
Mailing Address - Street 2:
Mailing Address - City:REDMOND
Mailing Address - State:OR
Mailing Address - Zip Code:97756-8308
Mailing Address - Country:US
Mailing Address - Phone:541-647-9921
Mailing Address - Fax:
Practice Address - Street 1:20370 POE SHOLES DR
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-7938
Practice Address - Country:US
Practice Address - Phone:541-647-9921
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-03-26
Last Update Date:2024-03-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health