Provider Demographics
NPI:1053122630
Name:MAYER-WALSH, JANET MIKKEL (NP)
Entity type:Individual
Prefix:
First Name:JANET
Middle Name:MIKKEL
Last Name:MAYER-WALSH
Suffix:
Gender:
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:105 W 8TH AVE STE 6010
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99204-2318
Mailing Address - Country:US
Mailing Address - Phone:509-838-5950
Mailing Address - Fax:509-838-5961
Practice Address - Street 1:105 W 8TH AVE STE 6010
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2318
Practice Address - Country:US
Practice Address - Phone:509-838-5950
Practice Address - Fax:509-838-5961
Is Sole Proprietor?:No
Enumeration Date:2025-01-14
Last Update Date:2025-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAAP61645556363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology