Provider Demographics
NPI:1508641911
Name:WALSH, AURORA CHRISTINE (PT, DPT)
Entity type:Individual
Prefix:DR
First Name:AURORA
Middle Name:CHRISTINE
Last Name:WALSH
Suffix:
Gender:F
Credentials:PT, DPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:625 KENMOOR AVE SE STE 100
Mailing Address - Street 2:
Mailing Address - City:GRAND RAPIDS
Mailing Address - State:MI
Mailing Address - Zip Code:49546-2395
Mailing Address - Country:US
Mailing Address - Phone:616-356-5000
Mailing Address - Fax:616-356-5001
Practice Address - Street 1:3925 SW 153RD DR STE 210
Practice Address - Street 2:
Practice Address - City:BEAVERTON
Practice Address - State:OR
Practice Address - Zip Code:97003-4176
Practice Address - Country:US
Practice Address - Phone:971-727-8155
Practice Address - Fax:971-727-8179
Is Sole Proprietor?:No
Enumeration Date:2023-08-25
Last Update Date:2024-10-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1382760225100000X
OR65500225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist