| Providence Smmc Multi-specialty Dme | |
|
301 W Poplar St Suite 210 Walla Walla WA 99362-2858 | |
| (509) 522-5825 | |
| (509) 529-3512 |
| Full Name | Providence Smmc Multi-specialty Dme |
|---|---|
| Speciality | Internal Medicine - Gastroenterology |
| Location | 301 W Poplar St, Walla Walla, Washington |
| Authorized Official Name and Position | Susan A Columber (RCM DIRECTOR) |
| Authorized Official Contact | 5095225906 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Providence Smmc Multi-specialty Dme 209 W Poplar St Po Box 1477 Walla Walla WA 99362-2828 Ph: (509) 522-5906 | Providence Smmc Multi-specialty Dme 301 W Poplar St Suite 210 Walla Walla WA 99362-2858 Ph: (509) 522-5825 |
| NPI Number | 1326282963 |
|---|---|
| Provider Enumeration Date | 04/27/2009 |
| Last Update Date | 04/27/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326282963 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RG0100X | Internal Medicine - Gastroenterology | HAC.FS00000050 (Washington) | Primary |
| 207Y00000X | Otolaryngology | HAC.FS.00000050 (Washington) | Secondary |
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