Organization
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Active
Organization
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Active
Parent organization
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Other names
Providence Medical Group Southeast Washington Rural Health Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Authorized official
MR. DONALD WAYNE ANDERSON (ASSISTANT SECRETARY OF ENROLLMENT)
(425) 358-9786
Entity
Organization
Contact information
Practice address
380 CHASE AVENUE, PMG SE WA RURAL HEALTH CLINIC, WALLA WALLA, WA 99362-2924
(509) 526-3333
(509) 526-8402
Mailing address
PO BOX 34439, MAILING/CREDENTIALING, SEATTLE, WA 98124-1439
(509) 529-8905
(509) 526-8402
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Enumeration date
09/28/2012
Last updated
05/06/2025
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