Provider Demographics
NPI:1649504549
Name:WALKER, KATIE TERESA (LPTA)
Entity type:Individual
Prefix:MRS
First Name:KATIE
Middle Name:TERESA
Last Name:WALKER
Suffix:
Gender:F
Credentials:LPTA
Other - Prefix:MRS
Other - First Name:KATIE
Other - Middle Name:TERESA
Other - Last Name:HIGHET
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PTA
Mailing Address - Street 1:14722 NE 169TH ST
Mailing Address - Street 2:
Mailing Address - City:WOODINVILLE
Mailing Address - State:WA
Mailing Address - Zip Code:98072-6941
Mailing Address - Country:US
Mailing Address - Phone:425-486-9933
Mailing Address - Fax:
Practice Address - Street 1:14722 NE 169TH ST
Practice Address - Street 2:
Practice Address - City:WOODINVILLE
Practice Address - State:WA
Practice Address - Zip Code:98072-6941
Practice Address - Country:US
Practice Address - Phone:425-486-9933
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-09-24
Last Update Date:2009-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAP160046045225200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225200000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapy Assistant