1. Home
  2. Directory
  3. Washington
  4. Walla Walla
  5. Clinic Center
  6. NPI Profile

WALLA WALLA CLINIC
NPI 1346441979
Clinic/Center - Rural Health in Walla Walla, WA

Active since May 30, 2007
55 W TIETAN ST, WALLA WALLA, WA 99362(509) 525-3720(509) 522-1292 Get Directions Write a Review

NPPES record last updated: October 6, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Walla Walla Clinic NPPES

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

WALLA WALLA CLINIC (NPI 1346441979) is a healthcare organization registered as a rural health in Walla Walla, Washington and active in the NPI registry since May 2007. The organization lists Kevin J Michelson, Ceo, as its authorized official.

NPPES Registry Identity

NPI1346441979
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NamePRIVIA MEDICAL GROUP WASHINGTON, PLLC
Location Address55 W TIETAN STWalla Walla, WA 99362-4445
Mailing Address55 W Tietan StWalla Walla, WA 99362-4445 · (509) 525-3720 · Fax (509) 522-1292
Phone(509) 525-3720
Fax(509) 522-1292
Organization SubpartNo
Authorized OfficialKevin J MichelsonCeo · (509) 525-3720
Enumeration DateMay 30, 2007
Last NPPES UpdateOctober 6, 2023
NPPES CertifiedOctober 6, 2023
✔ NPI 1346441979 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
License✔ Licensed in WA · FX00058422
55 W TIETAN ST, Walla Walla, WA 99362
Open in Google Maps ↗

Other Names 1

Doing Business AsWalla Walla Clinic

Other Identifiers 1

Medicaid7086820WA

Accepted Insurance

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

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.

KEVIN JON MOLANDER M.D.
Family Medicine
55 W TIETAN ST
WALLA WALLA, WA 99362
Walla Walla County (509) 525-3720
STACEY RENEE HAVEMAN PHYSICIAN ASSISTANT
Physician Assistant (Medical)
55 W TIETAN ST
WALLA WALLA, WA 99362
Walla Walla County (509) 525-3720
JUSTIN OLSWANGER DO
Family Medicine (Adult Medicine)
55 W TIETAN ST
WALLA WALLA, WA 99362
Walla Walla County (509) 525-3720
DR. JOHN ERIC MOORE D.O.
Family Medicine
55 W TIETAN ST
WALLA WALLA, WA 99362
Walla Walla County (509) 525-3720
TIMOTHY ISAMU O'CONNOR M.D.
Pediatrics
55 W TIETAN ST
WALLA WALLA, WA 99362
Walla Walla County (509) 525-3720
REBEKAH DICKMAN M.D.
Pediatrics
55 W TIETAN ST
WALLA WALLA, WA 99362
Walla Walla County (509) 525-3720
DIANA FITZGERALD AU.D.
Audiologist
55 W TIETAN ST
WALLA WALLA, WA 99362
Walla Walla County (509) 525-3720
GUNNAR LEIGHTON JAMES SJOREN DPT
Physical Therapist
55 W TIETAN ST
WALLA WALLA, WA 99362
Walla Walla County (509) 525-3720

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 Privia Medical Group Washington, PLLC's NPI number?

The NPI number for Privia Medical Group Washington, PLLC is 1346441979. It was assigned to this organization in the NPPES registry on May 30, 2007. The provider is doing business as Walla Walla Clinic.

Where is Privia Medical Group Washington, PLLC located?

Privia Medical Group Washington, PLLC is located at 55 W Tietan St, Walla Walla, WA 99362. The listed phone number is (509) 525-3720.

What is Privia Medical Group Washington, PLLC's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

What insurance does Privia Medical Group Washington, PLLC accept?

Health plans from Moda Health Plan, Inc. list Privia Medical Group Washington, PLLC 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.

When was this NPI record last updated?

The NPPES record for Privia Medical Group Washington, PLLC was last updated on October 6, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.