Individual
CRAIG R WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD MPH
Contact information
Practice address
9427 SW BARNES RD, SUITE 498, PORTLAND, OR 97225-6652
(503) 216-0900
Mailing address
PO BOX 3158, PORTLAND, OR 97208-3158
(503) 215-6494
(503) 215-6644
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
MD00049327
WA
207RC0000X
Cardiovascular Disease Physician
Primary
MD23763
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
286755
—
OR
05
—
8367153
—
WA
01
—
P00848629
RR MEDICARE
OR
01
—
P00991143
RR MEDICARE
WA
Enumeration date
06/05/2006
Last updated
03/25/2021
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