| Adventist Health Medical Group | |
|
1111 S 2nd Ave Walla Walla WA 99362-4118 | |
| (509) 522-0100 | |
| (509) 527-8010 |
| Full Name | Adventist Health Medical Group |
|---|---|
| Speciality | Clinic/center - Multi-specialty |
| Location | 1111 S 2nd Ave, Walla Walla, Washington |
| Authorized Official Name and Position | Monty E Knittel (CEO) |
| Authorized Official Contact | 5095250480 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Adventist Health Medical Group 1111 S 2nd Ave Walla Walla WA 99362-4118 Ph: (509) 522-0100 | Adventist Health Medical Group 1111 S 2nd Ave Walla Walla WA 99362-4118 Ph: (509) 522-0100 |
| NPI Number | 1780972562 |
|---|---|
| Provider Enumeration Date | 07/14/2011 |
| Last Update Date | 07/14/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780972562 | NPI | - | NPPES |
| 1093362 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Secondary |
| 261QM1300X | Clinic/center - Multi-specialty | (* (Not Available)) | Primary |
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