PRIVIA MEDICAL GROUP WASHINGTON, PLLC
NPI 1780658419
Clinic/Center in Walla Walla, WA
About Privia Medical Group Washington, Pllc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
PRIVIA MEDICAL GROUP WASHINGTON, PLLC (NPI 1780658419), doing business as Walla Walla Clinic (professional), is a healthcare organization registered as a clinic/center in Walla Walla, Washington and active in the NPI registry since February 2006. The organization lists Kevin Michelson, Ceo, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 2
Other Names 1
Other Identifiers 3
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Privia Medical Group Washington, Pllc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
78Medicare enrollment records show 78 clinicians reassign Medicare billing to Privia Medical Group Washington, PLLC, which bills Medicare for the services they deliver. Of these, 19 practice at this address and 38 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 19
Nearest to this location (20)
See all 78Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
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 1780658419. It was assigned to this organization in the NPPES registry on February 17, 2006. The provider is doing business as Walla Walla Clinic (Professional).
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 with taxonomy code 261Q00000X.
Is Privia Medical Group Washington, PLLC enrolled in Medicare?
Yes. Privia Medical Group Washington, PLLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Privia Medical Group Washington, PLLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 78 clinicians in 19 Medicare specialties reassign their Medicare billing to Privia Medical Group Washington, PLLC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Nurse Practitioner (20), Diagnostic Radiology (11) and Family Practice (11). Of these, 19 practice at this address and 38 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
What insurance does Privia Medical Group Washington, PLLC accept?
Health plans from Ambetter Health, Moda Health Plan, Inc., Premera Blue Cross Blue Shield of Alaska and Providence Health Plan 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 December 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 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.
# Privia Medical Group Washington, Pllc · NPI 1780658419
Clinic/Center organization in Walla Walla, Washington. Organization record, active in the CMS NPPES registry since February 17, 2006.
## Identity
- **NPI:** 1780658419 (Entity type: Organization)
- **Enumerated:** February 17, 2006
- **Primary specialty:** Clinic/Center · taxonomy 261Q00000X
- **Also known as:** Walla Walla Clinic (Professional) (Doing Business As)
- **Organization subpart:** No
- **Authorized official:** Kevin Michelson, CEO
## Practice location
- **Address:** 55 W TIETAN ST, Walla Walla, WA 99362-4445
- **Phone:** (509) 525-3720 · **Fax:** (509) 522-1592
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 78 clinicians in 19 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Nurse Practitioner (20), Diagnostic Radiology (11), Family Practice (11); 19 practice at this address and 38 within 10 miles; [full list](https://npiprofile.com/npi/1780658419/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** December 23, 2025
- **Other identifiers:** Medicaid 208199 (OR); Other 30200 (WA); Medicaid 7809205 (WA)
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Source: [NPI Profile](https://npiprofile.com/npi/1780658419) · Data from the CMS NPPES public registry.