Providence Health & Services - Washington

NPI #1154672947 in Walla Walla, Washington

Provider Information

NPI Number: 1154672947
Entity Type: Organization
Organization Name: Providence Health & Services - Washington
Subpart: Yes (part of a larger organization)
Parent Organization: PROVIDENCE HEALTH & SERVICES WASHINGTON
Primary Specialty: Family Medicine
Enumeration Date: Sep 20, 2012
Last Updated: May 6, 2025

Practice Location

Address: 380 CHASE AVENUE
Address 2: PMG SE WA RURAL HEALTH CLINIC
City: Walla Walla
State: Washington
ZIP Code: 99362-2924
Phone: (509) 526-3333

Authorized Official

Name: DONALD WAYNE ANDERSON
Title: ASSISTANT SECRETARY OF ENROLLMENTS
Phone: (425) 358-9786

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X
Physician Assistant	363A00000X
Nurse Practitioner	363L00000X
Family Medicine	207Q00000X	Primary

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