Individual
ERIC MARTIN WALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2505 2ND AVE, SEATTLE, WA 98121-1452
(206) 443-0400
(206) 520-1599
Mailing address
PO BOX 50095, SEATTLE, WA 98145-5095
(206) 543-6420
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
MD00018314
WA
207Q00000X
Family Medicine Physician
MD14497
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0236941
L&I
WA
05
—
1006220
—
WA
05
—
137919
—
OR
Enumeration date
08/01/2006
Last updated
04/23/2009
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