Provider Demographics
NPI:1720167570
Name:WALTON, HELEN J (CRNA)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:J
Last Name:WALTON
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1024
Mailing Address - Street 2:
Mailing Address - City:ISSAQUAH
Mailing Address - State:WA
Mailing Address - Zip Code:98027-0039
Mailing Address - Country:US
Mailing Address - Phone:425-392-8803
Mailing Address - Fax:425-392-8944
Practice Address - Street 1:1450 BATTERSBY AVE
Practice Address - Street 2:
Practice Address - City:ENUMCLAW
Practice Address - State:WA
Practice Address - Zip Code:98022-3634
Practice Address - Country:US
Practice Address - Phone:360-802-3243
Practice Address - Fax:360-802-3244
Is Sole Proprietor?:No
Enumeration Date:2006-11-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA0121785OtherL&I
WA7092034OtherDSHS
WA7092034OtherDSHS
WAAB04174Medicare ID - Type Unspecified