Provider Demographics
NPI:1952830333
Name:WALKER, KALEB E
Entity Type:Individual
Prefix:
First Name:KALEB
Middle Name:E
Last Name:WALKER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 S ASSEMBLY RD STE 300
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99224-2116
Mailing Address - Country:US
Mailing Address - Phone:509-892-9241
Mailing Address - Fax:509-892-9251
Practice Address - Street 1:1700 S ASSEMBLY RD STE 300
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99224-2116
Practice Address - Country:US
Practice Address - Phone:509-892-9241
Practice Address - Fax:509-892-9251
Is Sole Proprietor?:No
Enumeration Date:2017-06-08
Last Update Date:2022-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
Provider Identifiers
StateIdentifier IDID TypeIssuer
WAWALKEKE086QBOtherDRIVER'S LICENSE