Individual
ERIC WYATT WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3181 SW SAM JACKSON PARK RD., OREGON HEALTH AND SCIENCE UNIVERSITY, PORTLAND, OR 97239-3098
(503) 494-6616
(503) 494-4691
Mailing address
3181 SW SAM JACKSON PARK RD., OREGON HEALTH SCIENCES UNIVERSITY, PORTLAND, OR 97239
(503) 418-3900
(503) 418-8293
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17309
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00903700
—
NY
01
—
17309
LICENSE
OR
Enumeration date
10/25/2006
Last updated
08/21/2009
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