Provider Demographics
NPI:1386069896
Name:WALSH, DANIELLE M
Entity type:Individual
Prefix:
First Name:DANIELLE
Middle Name:M
Last Name:WALSH
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:900 7TH ST
Mailing Address - Street 2:
Mailing Address - City:CLARKSTON
Mailing Address - State:WA
Mailing Address - Zip Code:99403-2005
Mailing Address - Country:US
Mailing Address - Phone:509-758-3341
Mailing Address - Fax:
Practice Address - Street 1:440 MAXWELL RD
Practice Address - Street 2:
Practice Address - City:EUGENE
Practice Address - State:OR
Practice Address - Zip Code:97404-2355
Practice Address - Country:US
Practice Address - Phone:509-758-3341
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-20
Last Update Date:2025-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA1000001OtherSTATE OF WA