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Individual

JAMES WALSTON

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man

Contact information

Practice address
2211 NE 139TH ST, VANCOUVER, WA 98686-2742
(503) 413-8407
Mailing address
1640 9TH AVE SE, ROCHESTER, MN 55904-5478
(612) 210-0829

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
65708
MN
208000000X
Pediatrics Physician
Primary
MD213522
OR

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
65708
MINNESOTA BOARD OF MEDICAL PRACTICE
MN
Enumeration date
03/25/2016
Last updated
07/10/2024
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