Provider Demographics
NPI:1982718649
Name:WALKER, LYNDAL (PHD)
Entity Type:Individual
Prefix:
First Name:LYNDAL
Middle Name:
Last Name:WALKER
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:815 124TH ST SW
Mailing Address - Street 2:SPC 127
Mailing Address - City:EVERETT
Mailing Address - State:WA
Mailing Address - Zip Code:98204-5696
Mailing Address - Country:US
Mailing Address - Phone:425-299-3316
Mailing Address - Fax:
Practice Address - Street 1:2613 W MARINE VIEW DR
Practice Address - Street 2:
Practice Address - City:EVERETT
Practice Address - State:WA
Practice Address - Zip Code:98201-3420
Practice Address - Country:US
Practice Address - Phone:425-349-6700
Practice Address - Fax:425-349-6705
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2012-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WACG60144603101YM0800X
WACL60159121101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health