| Providence Medical Group Southeast Washington | |
|
380 Chase Ave Walla Walla WA 99362-2924 | |
| (509) 526-3333 | |
| Not Available |
| Full Name | Providence Medical Group Southeast Washington |
|---|---|
| Speciality | Family Medicine |
| Location | 380 Chase Ave, Walla Walla, Washington |
| Authorized Official Name and Position | Donald Anderson (ASST CORP SECRETARY FOR ENROLLMENTS) |
| Authorized Official Contact | 4255255392 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Medical Group Southeast Washington Po Box 32 Liberty Lake WA 99019-0032 Ph: () - | Providence Medical Group Southeast Washington 380 Chase Ave Walla Walla WA 99362-2924 Ph: (509) 526-3333 |
| NPI Number | 1326569682 |
|---|---|
| Provider Enumeration Date | 06/27/2017 |
| Last Update Date | 06/27/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326569682 | NPI | - | NPPES |
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