Provider Demographics
NPI:1730871757
Name:WALKER, KRISTINE CHARLENE (MSW)
Entity type:Individual
Prefix:
First Name:KRISTINE
Middle Name:CHARLENE
Last Name:WALKER
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1700 17TH AVE APT 300
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98122-2702
Mailing Address - Country:US
Mailing Address - Phone:206-739-2453
Mailing Address - Fax:
Practice Address - Street 1:502 RAINIER AVE S STE 204
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98144-1912
Practice Address - Country:US
Practice Address - Phone:206-678-7064
Practice Address - Fax:206-325-6516
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical