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General NPI Number Information
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NPI Number | 1316826225
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Entity Type | Individual
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Provider Name | JEDEDIAH WALSH
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Gender | Male
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Dates
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Enumeration Date | 08/27/2025
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 4555 DELRIDGE WAY SW
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City | SEATTLE
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State | WA
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Zip | 98106-1379
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Country | US
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Telephone | 206-937-7680
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Fax |
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Provider Business Mailing Address
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Address Line | 4555 DELRIDGE WAY SW
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City | SEATTLE
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State | WA
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Zip | 98106-1379
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TF0000X
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Taxonomy Name | Family Psychologist
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License Number |
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License Number State |
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