# DOUGLAS P. WALSH DDS

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1245372515
- **Authorized official:** DOUGLAS P WALSH DDS (DENTIST)
- **Authorized official phone:** (207) 762-8433

## Contact information

- **Practice address:** 9801 17TH AVE SW, SEATTLE, WA 98106-2759
- **Practice address phone:** (206) 762-8433
- **Mailing address:** 9801 17TH AVE SW, SEATTLE, WA 98106-2759
- **Mailing address phone:** (206) 762-8433

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 5109 | WA | Yes |

## Other

- **Enumeration date:** 02/13/2007
- **Last updated:** 08/22/2020

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 21287 | LABOR & INDUSTRIES | WA |
| 05 | — | 5562806 | — | WA |
| 01 | — | 788510 | UNITED CONCORDIA | — |
| 01 | — | WA0505 | REGENCE BLUE SHIELD RIDER | WA |