Provider Demographics
NPI:1982138780
Name:VALOR HEALTHCARE
Entity Type:Organization
Organization Name:VALOR HEALTHCARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINIC OPERATIONS DIRECTOR
Authorized Official - Prefix:MS
Authorized Official - First Name:JESSICA
Authorized Official - Middle Name:
Authorized Official - Last Name:WALCOTT
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:206-384-4382
Mailing Address - Street 1:12360 LAKE CITY WAY NE
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98125-5447
Mailing Address - Country:US
Mailing Address - Phone:206-384-4382
Mailing Address - Fax:206-440-3137
Practice Address - Street 1:12360 LAKE CITY WAY NE
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98125-5447
Practice Address - Country:US
Practice Address - Phone:206-384-4382
Practice Address - Fax:206-440-3137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-18
Last Update Date:2017-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WALW6016081261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care