Basic Information
Provider Information
NPI: 1790008282
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WALTER
FirstName: APRIL
MiddleName: LYNNE
NamePrefix: DR.
NameSuffix:  
Credential: PSY.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 33305 1ST WAY S
Address2: SUITE#B-203
City: FEDERAL WAY
State: WA
PostalCode: 980036235
CountryCode: US
TelephoneNumber: 2532355956
FaxNumber:  
Practice Location
Address1: 33305 1ST WAY S
Address2: SUITE#B-203
City: FEDERAL WAY
State: WA
PostalCode: 980036235
CountryCode: US
TelephoneNumber: 2532355956
FaxNumber:  
Other Information
ProviderEnumerationDate: 03/11/2010
LastUpdateDate: 09/13/2012
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
103TC0700XPY60134630WAY Behavioral Health & Social Service ProvidersPsychologistClinical

No ID Information.


Home