MISS NICHOELLE RENEE WALL PA
NPI 1407009418
Physician Assistant in Pasco, WA

Q: What is Nichoelle Wall's NPI number?

The NPI number for Nichoelle Wall is 1407009418. It was assigned to this individual provider in the NPPES registry on November 4, 2008. The provider is also known as Mrs. Nichoelle Renee Gourley PA.

Q: What is Nichoelle Wall's specialty?

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

Q: When was this NPI record last updated?

The NPPES record for Nichoelle Wall was last updated on April 15, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.

Active since November 04, 2008PECOS Enrolled

5304 N ROAD 68, PASCO, WA 99301(509) 543-9300(509) 542-3059 Get Directions Write a Review

NPPES record last updated: April 15, 2019. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Apr 15, 2019, Jan 25, 2017 (2 updates tracked since 2017).

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About Miss Nichoelle Renee Wall Pa NPPES

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

MISS NICHOELLE RENEE WALL PA (NPI 1407009418) is an individual physician assistant in Pasco, Washington, licensed in Oregon (PA156832) and active in the NPI registry since November 2008. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1407009418

Entity TypeIndividualFemale

Primary Taxonomy363A00000X

Provider Legal NameMISS NICHOELLE RENEE WALLCredential: PA

Location Address5304 N ROAD 68Pasco, WA 99301-8078

Mailing Address589 Nw 11th StHermiston, OR 97838-6600 · (541) 567-1717 · Fax (541) 564-5994

Phone(509) 543-9300

Fax(509) 542-3059

Sole ProprietorNo

Enumeration DateNovember 4, 2008

Last NPPES UpdateApril 15, 20192 updates tracked since enumeration

✔ NPI 1407009418 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 OR · PA156832

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.

5304 N ROAD 68, Pasco, WA 99301

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Other Names 1

Professional Name (2)Mrs. Nichoelle Renee Gourley Pa

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include PacificSource Health Plans.Insurance ›

Medicare Participation & PECOS CMS

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

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Miss Nichoelle Renee Wall Pa is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

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.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 99301 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 9

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

OUR LADY OF LOURDES HEALTH CENTER

Clinic/Center (Urgent Care)