Individual
STEPHEN LOUIS WALSTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
3236 78TH AVE SE STE 200, MERCER ISLAND, WA 98040-3500
(206) 386-9500
(206) 386-9605
Mailing address
PO BOX 25608, SALT LAKE CITY, UT 84125-0608
(206) 320-4476
(206) 568-7043
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD60423761
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1578887519
—
WA
05
—
2022131
—
WA
Enumeration date
03/19/2010
Last updated
11/11/2021
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