Individual
JUSTIN MICHAEL WALSH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LMP
Contact information
Practice address
1422 HARVARD AVE, SEATTLE, WA 98122-3813
(206) 465-3504
(206) 365-3433
Mailing address
2152 N 112TH ST UNIT 308, SEATTLE, WA 98133-8599
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MA00015947
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0155950
LABOR AND INDUSTRIES
WA
Enumeration date
03/26/2007
Last updated
07/08/2007
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