Provider Demographics
NPI:1083135834
Name:WALSH, SYLVIA (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:SYLVIA
Middle Name:
Last Name:WALSH
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:SYLVIA
Other - Middle Name:
Other - Last Name:WALSH
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:PHARMD
Mailing Address - Street 1:5840 REED LN SE APT 135
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:OR
Mailing Address - Zip Code:97306-2987
Mailing Address - Country:US
Mailing Address - Phone:971-301-4052
Mailing Address - Fax:
Practice Address - Street 1:1175 MOUNT HOOD AVE
Practice Address - Street 2:
Practice Address - City:WOODBURN
Practice Address - State:OR
Practice Address - Zip Code:97071-9060
Practice Address - Country:US
Practice Address - Phone:503-982-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-02
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ORRPH-0016173183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist