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PROVIDENCE HEALTH & SERVICES - WASHINGTON
NPI 1306097126
Radiology - Diagnostic Radiology in Walla Walla, WA

Active since October 10, 2008
401 W POPLAR STREET, PMG SE WA IMAGING, WALLA WALLA, WA 99362(509) 522-5850(509) 526-8402 Get Directions Write a Review

NPPES record last updated: May 6, 2025. Verified against the NPPES registry weekly; last sync: July 19, 2026.

Record update history: May 6, 2025, Feb 10, 2025, Nov 11, 2024 (3 updates tracked since 2024).

About Providence Health & Services - Washington NPPES

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

PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI 1306097126), doing business as Providence Medical Group Southeast Washington Imaging, is a healthcare organization registered as a diagnostic radiology in Walla Walla, Washington and active in the NPI registry since October 2008. The organization lists Donald W. Anderson, Assistant Secretary Of Enrollments, as its authorized official.

NPPES Registry Identity

NPI1306097126
Entity TypeOrganization
Primary Taxonomy2085R0202X
Legal Business NamePROVIDENCE HEALTH & SERVICES - WASHINGTON
Location Address401 W POPLAR STREET, PMG SE WA IMAGINGWalla Walla, WA 99362-2846
Mailing AddressPo Box 31001-4114Pasadena, CA 91110-4114 · (509) 529-8905 · Fax (509) 526-8402
Phone(509) 522-5850
Fax(509) 526-8402
Organization SubpartYes
Authorized OfficialDonald W. AndersonAssistant Secretary Of Enrollments · (425) 358-9786
Enumeration DateOctober 10, 2008
Last NPPES UpdateMay 6, 20253 updates tracked since enumeration
NPPES CertifiedMay 6, 2025
✔ NPI 1306097126 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyRadiology · Diagnostic RadiologyAllopathic & Osteopathic Physicians
Taxonomy Code2085R0202X
Definition

A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.

401 W POPLAR STREET, Walla Walla, WA 99362
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Other Names 1

Doing Business AsProvidence Medical Group Southeast Washington Imaging

Other Identifiers 3

Other191431900WA · L&i Federal
Medicaid7138118WA
Other222605WA · L&i State

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska.Insurance ›

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

JOSHUA BETHKE
Nurse Practitioner (Adult Health)
401 W POPLAR STREET
WALLA WALLA, WA 99362
Walla Walla County (509) 897-3320
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Radiology (Radiation Oncology)
401 W POPLAR STREET, PMG SE WA RADIATION ONCOLOGY
WALLA WALLA, WA 99362
Walla Walla County (509) 522-5700

Frequently Asked Questions

What is PROVIDENCE HEALTH & SERVICES - WASHINGTON's NPI number?

The NPI number assigned to this healthcare provider is 1306097126, enumerated as an "organization" on October 10, 2008.

Where is the provider located?

The provider is located at 401 W POPLAR STREET PMG SE WA IMAGING WALLA WALLA, WA 99362 and the phone number is (509) 522-5850.

What is the provider's specialty?

Radiology with taxonomy code 2085R0202X and a focus in Diagnostic Radiology.

What insurance does PROVIDENCE HEALTH & SERVICES - WASHINGTON accept?

The provider might be accepting Accepts: Moda Health Plan, Inc., Premera Blue Cross Blue. Please consult your insurance carrier or call the provider to verify.