Provider Demographics
NPI:1023882214
Name:WALKER, CLAIR HAL
Entity type:Individual
Prefix:
First Name:CLAIR
Middle Name:HAL
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 1:4506 N TATTENHAM WAY
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83713-2524
Mailing Address - Country:US
Mailing Address - Phone:208-841-7698
Mailing Address - Fax:208-841-7698
Practice Address - Street 1:4506 N TATTENHAM WAY
Practice Address - Street 2:
Practice Address - City:BOISE
Practice Address - State:ID
Practice Address - Zip Code:83713-2524
Practice Address - Country:US
Practice Address - Phone:208-841-7698
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-11-08
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376J00000XNursing Service Related ProvidersHomemaker
No133NN1002XDietary & Nutritional Service ProvidersNutritionistNutrition, Education
No171400000XOther Service ProvidersHealth & Wellness Coach
No174200000XOther Service ProvidersMeals
No177F00000XOther Service ProvidersLodging
No347C00000XTransportation ServicesPrivate Vehicle
No372600000XNursing Service Related ProvidersAdult Companion