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NPI Code Detail

MEDICARE: JEFFREY D WALROD

MEDICARE: JEFFREY D WALROD
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
11041C0700XClinical Social WorkerBBH-LCSW-LIC-84891MT

General Provider Information

NPI Number : 1689538290
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEFFREY D WALROD
Provider Business Mailing Address
First Line : 111 HILLCREST LOOP
Second Line :
City : MISSOULA
State : MT
Zip : 59803-1630
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 3885 W BROADWAY ST
Second Line :
City : MISSOULA
State : MT
Zip : 59808-5796
Country : US
Telephone Number : 406-447-6000
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/10/2025
Last Update Date : 12/10/2025

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