Individual provider Active NPI

Sherman Walker, MA-PC

  • Phlebotomy Technician
  • Renton, WA
National Provider Identifier
1306642111
Registry record updated Feb 21, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Phlebotomy TechnicianTaxonomy code 246RP1900X
License
PC60379320 Issued in WA
Practice address
2007 Camas Ave NE
Renton, WA 98056-2780
Phone
(425) 970-5461
Fax
(206) 519-6701
NPI assigned
Feb 21, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 21, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Phlebotomy Technician 246RP1900X PC60379320 WA Primary

Addresses

Primary practice location

2007 Camas Ave NE
Renton, WA 98056-2780

Mailing address

2007 Camas Ave NE
Renton, WA 98056-2780
Phone (425) 970-5461

Other practice location 1

15101 SE 272nd St
Kent, WA 98042-4305
Phone (425) 970-5461

Other practice location 2

1400 112th Ave SE Ste 100
Bellevue, WA 98004-6901
Phone (425) 970-5461

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
PC60379320WAMDPhlebotomy Technician

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1740096000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740096000000",
    "number": "1306642111",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2007 CAMAS AVE NE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980562780",
            "telephone_number": "425-970-5461",
            "fax_number": "206-519-6701"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2007 CAMAS AVE NE",
            "city": "RENTON",
            "state": "WA",
            "postal_code": "980562780",
            "telephone_number": "425-970-5461",
            "fax_number": "206-519-6701"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "15101 SE 272nd St",
            "address_purpose": "LOCATION",
            "city": "Kent",
            "state": "WA",
            "postal_code": "980424305",
            "country_code": "US",
            "telephone_number": "425-970-5461",
            "fax_number": "206-519-6701",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1400 112th Ave SE Ste 100",
            "address_purpose": "LOCATION",
            "city": "Bellevue",
            "state": "WA",
            "postal_code": "980046901",
            "country_code": "US",
            "telephone_number": "425-970-5461",
            "fax_number": "206-519-6701",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "SHERMAN",
        "credential": "MA-PC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-02-21",
        "last_updated": "2025-02-21",
        "certification_date": "2025-02-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246RP1900X",
            "taxonomy_group": "",
            "desc": "Technician, Pathology, Phlebotomy",
            "state": "WA",
            "license": "PC60379320",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Renton, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 21, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.