Provider Demographics
NPI:1689441594
Name:WALSDORF, AARON LEE (FNP)
Entity Type:Individual
Prefix:MR
First Name:AARON
Middle Name:LEE
Last Name:WALSDORF
Suffix:
Gender:M
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5223 N VISTA CT
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99212-1639
Mailing Address - Country:US
Mailing Address - Phone:509-953-1267
Mailing Address - Fax:
Practice Address - Street 1:5223 N VISTA CT
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99212-1639
Practice Address - Country:US
Practice Address - Phone:509-953-1267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-11
Last Update Date:2023-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAF11230750363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner