Individual
RUSSELL K WALSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
1551 E TANGERINE RD, ORO VALLEY, AZ 85755-6213
(520) 901-3500
Mailing address
PO BOX 6210, FARMINGTON, NM 87499-6210
(505) 609-2258
(505) 609-2259
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
8000945-3102
UT
367500000X
Certified Registered Nurse Anesthetist
Primary
CRNA-01530
NM
Other
Enumeration date
09/25/2017
Last updated
04/23/2025
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