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NPI Code Detail

MEDICARE: PAUL JASON WALSH

MEDICARE: PAUL JASON WALSH
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1106H00000XMarriage & Family TherapistT1413OR

General Provider Information

NPI Number : 1104012988
Entity Type Code : Individual
Provider Name (Legal Business Name) : PAUL JASON WALSH
Provider Business Mailing Address
First Line : 1050 SW 6TH AVE STE 1100
Second Line :
City : PORTLAND
State : OR
Zip : 97204-1153
Country : US
Telephone Number : 503-208-4911
Fax Number :
Provider Business Practice Location Address
First Line : 1110 SE ALDER ST STE 301
Second Line :
City : PORTLAND
State : OR
Zip : 97214-2400
Country : US
Telephone Number : 503-208-4911
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/14/2007
Last Update Date : 01/31/2026

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Directions to “ PAUL JASON WALSH ” Practice Location

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