Provider Demographics
NPI:1356770150
Name:WALSH, NATHAN E (ND)
Entity type:Individual
Prefix:DR
First Name:NATHAN
Middle Name:E
Last Name:WALSH
Suffix:
Gender:M
Credentials:ND
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:230 14TH AVE E APT 202
Mailing Address - Street 2:
Mailing Address - City:SEATTLE
Mailing Address - State:WA
Mailing Address - Zip Code:98112-5203
Mailing Address - Country:US
Mailing Address - Phone:480-236-2199
Mailing Address - Fax:
Practice Address - Street 1:230 14TH AVE E APT 202
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98112-5203
Practice Address - Country:US
Practice Address - Phone:480-236-2199
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-02
Last Update Date:2013-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WANT60421737175F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes175F00000XOther Service ProvidersNaturopath