Provider Demographics
NPI:1841156510
Name:WALTON, SAMANTHA MICHELLE (RDN)
Entity type:Individual
Prefix:MS
First Name:SAMANTHA
Middle Name:MICHELLE
Last Name:WALTON
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2644 HARRIS AVE
Mailing Address - Street 2:
Mailing Address - City:RICHLAND
Mailing Address - State:WA
Mailing Address - Zip Code:99354-1640
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:120 SOUTH RIVERSIDE PLAZA, SUITE 2190
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60606-6995
Practice Address - Country:US
Practice Address - Phone:312-899-0040
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-12-26
Last Update Date:2025-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered