Provider Demographics
NPI:1730216375
Name:ROYLE, WALTER ARTHUR (LMP)
Entity type:Individual
Prefix:MR
First Name:WALTER
Middle Name:ARTHUR
Last Name:ROYLE
Suffix:
Gender:M
Credentials:LMP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1101 NE 84TH AVE
Mailing Address - Street 2:
Mailing Address - City:VANCOUVER
Mailing Address - State:WA
Mailing Address - Zip Code:98664-1824
Mailing Address - Country:US
Mailing Address - Phone:360-693-4936
Mailing Address - Fax:
Practice Address - Street 1:6202 NE HIGHWAY 99
Practice Address - Street 2:SUITE #4
Practice Address - City:VANCOUVER
Practice Address - State:WA
Practice Address - Zip Code:98665-8747
Practice Address - Country:US
Practice Address - Phone:360-695-6055
Practice Address - Fax:360-735-7628
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMA00011928174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist