DOUGLAS EDISON WEST PAC
NPI 1104884295
Physician Assistant in Walla Walla, WA

Active since May 01, 2006PECOS EnrolledAccepts Medicare Assignment
301 W POPLAR ST, STE 220, WALLA WALLA, WA 99362(509) 522-1030(509) 529-6066 Get Directions Write a Review

NPPES record last updated: March 1, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Douglas Edison West Pac NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DOUGLAS EDISON WEST PAC (NPI 1104884295) is an individual physician assistant in Walla Walla, Washington, licensed in Washington (PA10003131) and active in the NPI registry since May 2006. He is enrolled in Medicare PECOS, is affiliated with Prov Sacred Hrt Med Ctr & Childs Hosp., and maintains a secondary practice location in Spokane.

NPPES Registry Identity

NPI1104884295
Entity TypeIndividualMale
Primary Taxonomy363A00000X
Provider Legal NameDOUGLAS EDISON WESTCredential: PAC
Location Address301 W POPLAR ST, STE 220Walla Walla, WA 99362-2858
Mailing AddressPo Box 32Liberty Lake, WA 99019-0032 · (509) 529-8905
Fax(509) 529-6066
Sole ProprietorNo
Medical School CMSOtherGraduated 1993
Enumeration DateMay 1, 2006
Last NPPES UpdateMarch 1, 2021
NPPES CertifiedMarch 1, 2021
NPI 1104884295 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
License Licensed in WA · PA10003131
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
301 W POPLAR ST, Walla Walla, WA 99362

Secondary Practice Location 1

Location 1101 W 8th AveSpokane, WA 99204-2307 · Phone (509) 459-3583 · Fax (509) 482-1856

Other Identifiers 3

Medicaid8377525WA
Medicaid500604784OR
Medicaid806824800ID

Accepted Insurance

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare and accepts Medicare assignment

Douglas Edison West Pac is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID42101826
PECOS Enrollment IDI20040322001343
Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes 99223
Initial hospital inpatient care per day, typically 70 minutes, refers to the daily medical service provided to patients admitted to the hospital. This includes a comprehensive evaluation, diagnosis, treatment plan, and monitoring of your health condition. It ensures your well-being during your hospital stay.
24 services24 patients
Initial hospital care with straightforward or low-level medical decision making, if using time, at least 55 minutes 99222
Initial hospital inpatient care is a service where a healthcare provider spends about 50 minutes per day overseeing your care while you're admitted in the hospital. This includes reviewing your health status, planning your treatment, and ensuring your safety and comfort.
12 services12 patients
Critical care, first 30-74 minutes 99291
Critical care involves immediate and constant attention by a team of specially-trained health professionals. It's for patients with life-threatening conditions, requiring first 30-74 minutes of intense monitoring and treatment.
11 services11 patients

Hospital Affiliations CMS Care Compare 2

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

Prov Sacred Hrt Med Ctr & Childs Hosp.

Acute Care Hospitals · Spokane, WA
3/5 CMS rating
OwnershipVoluntary non-profit - Church
CMS Certification Number500054
Location101 West 8th AvenueSpokane, WA 99204 · Spokane County
Emergency services Birthing friendly

Providence Holy Family Hospital

Acute Care Hospitals · Spokane, WA
3/5 CMS rating
OwnershipVoluntary non-profit - Private
CMS Certification Number500077
Location5633 North LidgerwoodSpokane, WA 99208 · Spokane County
Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99362 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$88.29 typical visit price
range $57.27 – $172.80
Typical copayment $22.07 (range $14.31 – $43.20)
Most-billed visit code 99203
Established Patient
$71.29 typical visit price
range $18.56 – $141.11
Typical copayment $17.82 (range $4.64 – $35.27)
Most-billed visit code 99213
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Psychiatry & Neurology (Neurology)
301 W POPLAR ST, SUITE 230
WALLA WALLA, WA 99362
Neurological Surgery
301 W POPLAR ST, STE 220
WALLA WALLA, WA 99362
Durable Medical Equipment & Medical Supplies
301 W POPLAR ST
WALLA WALLA, WA 99362
Neurological Surgery
301 W POPLAR ST
WALLA WALLA, WA 99362
Surgery
301 W POPLAR ST, SUITE 50
WALLA WALLA, WA 99362
Internal Medicine (Nephrology)
301 W POPLAR ST, SUITE 100
WALLA WALLA, WA 99362
Audiologist
301 W POPLAR ST, STE 210
WALLA WALLA, WA 99362
Internal Medicine (Gastroenterology)
301 W POPLAR ST, SUITE 210
WALLA WALLA, WA 99362

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Douglas West's NPI number?

The NPI number for Douglas West is 1104884295. It was assigned to this individual provider in the NPPES registry on May 1, 2006.

Where is Douglas West located?

Douglas West practices at 301 W Poplar St Ste 220, Walla Walla, WA 99362. The listed phone number is (509) 522-1030.

What is Douglas West's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Is Douglas West enrolled in Medicare?

Yes. Douglas West is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

What insurance does Douglas West accept?

Health plans from PacificSource Health Plans, Premera Blue Cross Blue Shield of Alaska and Providence Health Plan list Douglas West as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

Is Douglas West affiliated with any hospitals?

According to CMS data, Douglas West is affiliated with Prov Sacred Hrt Med Ctr & Childs Hosp. and Providence Holy Family Hospital.

When was this NPI record last updated?

The NPPES record for Douglas West was last updated on March 1, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.