PROVIDENCE HEALTH & SERVICES - WASHINGTON
NPI 1891046926
Clinic/Center - Rural Health in Walla Walla, WA

Active since September 28, 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 09, 2026.

About Providence Health & Services - Washington NPPES

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

PROVIDENCE HEALTH & SERVICES - WASHINGTON (NPI 1891046926), doing business as Providence Medical Group Southeast Washington Rural Health Clinic, is a healthcare organization registered as a rural health in Walla Walla, Washington and active in the NPI registry since September 2012. The organization lists Donald Wayne Anderson, Assistant Secretary Of Enrollment, as its authorized official.

NPPES Registry Identity

NPI1891046926
Entity TypeOrganization
Primary Taxonomy261QR1300X
Legal Business NamePROVIDENCE HEALTH & SERVICES - WASHINGTON
Location Address380 CHASE AVENUE, PMG SE WA RURAL HEALTH CLINICWalla Walla, WA 99362-2924
Mailing AddressPo Box 34439, Mailing/credentialingSeattle, WA 98124-1439 · (509) 529-8905 · Fax (509) 526-8402
Fax(509) 526-8402
Organization SubpartYes
Authorized OfficialDonald Wayne AndersonAssistant Secretary Of Enrollment · (425) 358-9786
Enumeration DateSeptember 28, 2012
Last NPPES UpdateMay 6, 2025
NPPES CertifiedMay 6, 2025
NPI 1891046926 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Primary SpecialtyClinic/Center · Rural HealthAmbulatory Health Care Facilities
Taxonomy Code261QR1300X
380 CHASE AVENUE, Walla Walla, WA 99362

Other Names 1

Doing Business AsProvidence Medical Group Southeast Washington Rural Health Clinic

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.

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

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 1891046926. It was assigned to this organization in the NPPES registry on September 28, 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 Clinic/Center, specializing in Rural Health, with taxonomy code 261QR1300X.

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.