Provider Demographics
NPI:1538825039
Name:WALKER, JAHALA ROSE (LMT)
Entity type:Individual
Prefix:
First Name:JAHALA
Middle Name:ROSE
Last Name:WALKER
Suffix:
Gender:F
Credentials:LMT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8400 E YALE AVE APT 7-204
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80231-3856
Mailing Address - Country:US
Mailing Address - Phone:970-481-6757
Mailing Address - Fax:
Practice Address - Street 1:15200 E GIRARD AVE STE 3100
Practice Address - Street 2:
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80014-5002
Practice Address - Country:US
Practice Address - Phone:970-481-6757
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-11-10
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COMT.0021098225700000X
374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No225700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersMassage Therapist