Provider Demographics
NPI:1932241163
Name:WALKER, SUSAN D (MA)
Entity Type:Individual
Prefix:MS
First Name:SUSAN
Middle Name:D
Last Name:WALKER
Suffix:
Gender:F
Credentials:MA
Other - Prefix:MS
Other - First Name:SUSAN
Other - Middle Name:D
Other - Last Name:WALKER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MA
Mailing Address - Street 1:1018 NE 112TH ST
Mailing Address - Street 2:APT 201
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125
Mailing Address - Country:US
Mailing Address - Phone:206-854-3943
Mailing Address - Fax:
Practice Address - Street 1:1015 NE 113TH ST
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125
Practice Address - Country:US
Practice Address - Phone:206-363-9601
Practice Address - Fax:206-363-9639
Is Sole Proprietor?:No
Enumeration Date:2007-02-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARC00048929101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health