Provider Demographics
NPI:1407637887
Name:WALSH, PATRICK GLEN (RN)
Entity Type:Individual
Prefix:
First Name:PATRICK
Middle Name:GLEN
Last Name:WALSH
Suffix:
Gender:M
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 E CHESTNUT ST STE 200
Mailing Address - Street 2:
Mailing Address - City:BELLINGHAM
Mailing Address - State:WA
Mailing Address - Zip Code:98225-5241
Mailing Address - Country:US
Mailing Address - Phone:360-788-8143
Mailing Address - Fax:
Practice Address - Street 1:800 E CHESTNUT ST STE 200
Practice Address - Street 2:
Practice Address - City:BELLINGHAM
Practice Address - State:WA
Practice Address - Zip Code:98225-5241
Practice Address - Country:US
Practice Address - Phone:360-788-8143
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-10-11
Last Update Date:2023-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WARN60822703163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health