Healthcare Provider Details

I. General information

NPI: 1407353329
Provider Name (Legal Business Name): ASHLEY MARIE WALSWORTH PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/08/2018
Last Update Date: 11/03/2025
Certification Date: 11/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4809 ARGONNE ST STE 100
DENVER CO
80249-6835
US

IV. Provider business mailing address

2695 ROCKY MOUNTAIN AVE STE 150
LOVELAND CO
80538-9071
US

V. Phone/Fax

Practice location:
  • Phone: 303-371-0330
  • Fax: 303-344-0200
Mailing address:
  • Phone: 970-624-2409
  • Fax: 970-490-4155

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number0005325
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: