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NPI Code Detail

MEDICARE: DR. DOUGLAS PAUL WALSH DDS

MEDICARE:  DR. DOUGLAS PAUL WALSH  DDS
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
11223G0001XGeneral Practice Dentistry5109WA

General Provider Information

NPI Number : 1194728931
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS PAUL WALSH DDS
Provider Business Mailing Address
First Line : 9801 17TH AVE SW
Second Line :
City : SEATTLE
State : WA
Zip : 98106-2759
Country : US
Telephone Number : 206-762-8433
Fax Number : 206-767-5581
Provider Business Practice Location Address
First Line : 9801 17TH AVE SW
Second Line :
City : SEATTLE
State : WA
Zip : 98106-2759
Country : US
Telephone Number : 206-762-8433
Fax Number : 206-767-5581
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/24/2005
Last Update Date : 07/08/2007

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Directions to “ DR. DOUGLAS PAUL WALSH DDS” Practice Location

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