Basic Information
Provider Information
NPI: 1902326903
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BARFIELD
FirstName: WALTER
MiddleName:  
NamePrefix:  
NameSuffix:  
Credential: LICENSED MHP
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3857 MARTIN WAY E
Address2:  
City: OLYMPIA
State: WA
PostalCode: 985065268
CountryCode: US
TelephoneNumber: 3607047170
FaxNumber:  
Practice Location
Address1: 3857 MARTIN WAY E
Address2:  
City: OLYMPIA
State: WA
PostalCode: 98506
CountryCode: US
TelephoneNumber: 3607047170
FaxNumber:  
Other Information
ProviderEnumerationDate: 06/21/2017
LastUpdateDate: 07/21/2022
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
101YM0800XLH00006450WAY Behavioral Health & Social Service ProvidersCounselorMental Health

No ID Information.


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