PROVIDENCE HEALTH & SERVICES - WASHINGTON
NPI 1154672947
Family Medicine in Walla Walla, WA

Q: What is Providence Health & Services - Washington's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Active since September 20, 2012

380 CHASE AVENUE, PMG SE WA RURAL HEALTH CLINIC, WALLA WALLA, WA 99362(509) 526-3333(509) 526-8402 Get Directions Write a Review

NPPES record last updated: May 6, 2025. Verified against the NPPES registry weekly; last sync: August 30, 2026.

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About Providence Health & Services - Washington NPPES

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

PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI 1154672947), doing business as Providence Medical Group Southeast Washington Rural Health Clinic, is a healthcare organization registered as a family medicine in Walla Walla, Washington and active in the NPI registry since September 2012. The organization lists Donald Wayne Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1154672947

Entity TypeOrganization

Primary Taxonomy207Q00000X

Legal Business NamePROVIDENCE HEALTH & SERVICES - WASHINGTON

Location Address380 CHASE AVENUE, PMG SE WA RURAL HEALTH CLINICWalla Walla, WA 99362-2924

Mailing AddressPo Box 34439, Pmg Se Wa Rural Health ClinicSeattle, WA 98124-1439 · (509) 526-3333 · Fax (509) 526-8402

Phone(509) 526-3333

Fax(509) 526-8402

Organization SubpartYesParent: Providence Health & Services Washington

Authorized OfficialDonald Wayne AndersonAssistant Secretary Of Enrollments · (425) 358-9786

Enumeration DateSeptember 20, 2012

Last NPPES UpdateMay 6, 2025

NPPES CertifiedMay 6, 2025

✔ NPI 1154672947 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedPhysician AssistantTaxonomy 363A00000X

Also ListedNurse PractitionerTaxonomy 363L00000X

380 CHASE AVENUE, Walla Walla, WA 99362

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Other Names 1

Doing Business AsProvidence Medical Group Southeast Washington Rural Health Clinic

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 2

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

PROVIDENCE HEALTH & SERVICES - WASHINGTON

Clinic/Center (Rural Health)

380 CHASE AVENUE, PMG SE WA RURAL HEALTH CLINIC
WALLA WALLA, WA 99362

Walla Walla County (509) 526-3333

PROVIDENCE HEALTH & SERVICES - WASHINGTON

Family Medicine

380 CHASE AVENUE, PMG SE WA
WALLA WALLA, WA 99362

Walla Walla County (509) 526-3333

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 Providence Health & Services - Washington's NPI number?

The NPI number for Providence Health & Services - Washington is 1154672947. It was assigned to this organization in the NPPES registry on September 20, 2012. The provider is doing business as Providence Medical Group Southeast Washington Rural Health Clinic.

Where is Providence Health & Services - Washington located?

Providence Health & Services - Washington is located at 380 Chase Avenue Pmg SE Wa Rural Health Clinic, Walla Walla, WA 99362. The listed phone number is (509) 526-3333.

What is Providence Health & Services - Washington's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

When was this NPI record last updated?

The NPPES record for Providence Health & Services - Washington was last updated on May 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 15 months 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.