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534 S 3rd Ave Ste B-101 Walla Walla WA 99362-3177 | |
| (509) 529-5661 | |
| Not Available |
| Full Name | |
|---|---|
| Speciality | Clinic/center - Student Health |
| Location | 534 S 3rd Ave Ste B-101, Walla Walla, Washington |
| Authorized Official Name and Position | Norma L Hernandez (EXECUTIVE DIRECTOR) |
| Authorized Official Contact | 5095295661 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
Po Box 1075 Walla Walla WA 99362-0021 Ph: (509) 529-1692 | 534 S 3rd Ave Ste B-101 Walla Walla WA 99362-3177 Ph: (509) 529-5661 |
| NPI Number | 1720313026 |
|---|---|
| Provider Enumeration Date | 10/05/2009 |
| Last Update Date | 07/05/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1720313026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QS1000X | Clinic/center - Student Health | (* (Not Available)) | Primary |
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