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Organization
WALLA WALLA CLINIC, INC.
Active
Organization
WALLA WALLA CLINIC, INC.
Active
Other names
Walla Walla Clinic Ambulatory Surgery Center
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN J MICHELSON (CEO)
(509) 525-3720
Entity
Organization
Contact information
Practice address
55 W TIETAN ST, WALLA WALLA, WA 99362-4445
(509) 525-3720
(509) 522-1593
Mailing address
55 W TIETAN ST, WALLA WALLA, WA 99362-4445
(509) 525-3720
(509) 522-1593
Taxonomy
Speciality
Code
Description
License number
State
261QA1903X
Ambulatory Surgical Clinic/Center
Primary
FX00058422
WA
Other
Enumeration date
10/27/2006
Last updated
07/23/2014
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