Basic Information
Provider Information
NPI: 1477614386
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: WALKER
FirstName: SARA
MiddleName: CAREEN
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 14900
Address2: STATE OF OREGON IRS UNIT
City: SALEM
State: OR
PostalCode: 973095016
CountryCode: US
TelephoneNumber: 5039459840
FaxNumber:  
Practice Location
Address1: 2600 CENTER ST NE
Address2: OREGON STATE HOSPITAL
City: SALEM
State: OR
PostalCode: 97301
CountryCode: US
TelephoneNumber: 5039452800
FaxNumber:  
Other Information
ProviderEnumerationDate: 12/13/2006
LastUpdateDate: 07/08/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2084P0800XMD26982ORY Allopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry

No ID Information.


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