Individual provider Active NPI

Kevin Michael Walker, PHARMD

  • Pharmacist
  • Spokane, WA
National Provider Identifier
1376887901
Registry record updated Nov 20, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
PH 60297871 Issued in WA
Practice address
104 S Freya St
#217 Lilac Flag Building
Spokane, WA 99202-4862
Phone
(509) 831-7621
NPI assigned
Nov 20, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 20, 2012

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X PH 60297871 WA Primary
Geriatric Pharmacist 1835G0303X PH 60297871 WA
Nutrition Support Pharmacist 1835N1003X PH 60297871 WA
Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist 1835P0018X PH 60297871 WA

Addresses

Primary practice location

104 S Freya St
#217 Lilac Flag Building
Spokane, WA 99202-4862

Mailing address

104 S Freya St
#217 Lilac Flag Building
Spokane, WA 99202-4862

Other identifiers 1

IdentifierTypeStateIssuer
PH 60297871OtherWAPHARMACIST LICENSE CREDENTIAL NUMBER

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
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
PH 60297871WAMDPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist

NPI Registry JSON

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

{
    "created_epoch": "1353369600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1353369600000",
    "number": "1376887901",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "104 S FREYA ST",
            "address_2": "#217 LILAC FLAG BUILDING",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024862"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 S FREYA ST",
            "address_2": "#217 LILAC FLAG BUILDING",
            "city": "SPOKANE",
            "state": "WA",
            "postal_code": "992024862",
            "telephone_number": "509-831-7621"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALKER",
        "first_name": "KEVIN",
        "middle_name": "MICHAEL",
        "name_prefix": "Dr.",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-11-20",
        "last_updated": "2012-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "WA",
            "license": "PH 60297871",
            "primary": true
        },
        {
            "code": "1835G0303X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Geriatric",
            "state": "WA",
            "license": "PH 60297871",
            "primary": false
        },
        {
            "code": "1835N1003X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Nutrition Support",
            "state": "WA",
            "license": "PH 60297871",
            "primary": false
        },
        {
            "code": "1835P0018X",
            "taxonomy_group": "",
            "desc": "Pharmacist, Pharmacist Clinician (PhC)/ Clinical Pharmacy Specialist",
            "state": "WA",
            "license": "PH 60297871",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHARMACIST LICENSE CREDENTIAL NUMBER",
            "identifier": "PH 60297871",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Spokane, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2012; 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.