<unavail> in College Place, WA - Medicare Internal Medicine

is a medicare enrolled primary clinic (Internal Medicine) in College Place, Washington. The current practice location for is 56 N College Ave Unit 2a, College Place, Washington. For appointments, you can reach them via phone at (097) 300-7285. The mailing address for is 146 Thunder Ridge Dr, Walla Walla, Washington and phone number is (518) 801-6446.

is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1275215972. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (097) 300-7285.

Contact Information


	56 N College Ave Unit 2a College Place WA 99324-1048
	(097) 300-7285
	(866) 531-7606

Map and Direction

Primary Care Clinic Profile

Full Name
Speciality	Internal Medicine
Location	56 N College Ave Unit 2a, College Place, Washington
Authorized Official Name and Position	Oleksandr Seleverstov (OWNER)
Authorized Official Contact	5188016446
Accepts Medicare Insurance	Yes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing Address	Practice Location Address
146 Thunder Ridge Dr Walla Walla WA 99362-7762 Ph: (518) 801-6446	56 N College Ave Unit 2a College Place WA 99324-1048 Ph: (097) 300-7285

NPI Details:

NPI Number	1275215972
Provider Enumeration Date	08/02/2023
Last Update Date	01/29/2025

Medicare PECOS Information:

Medicare PECOS PAC ID	5395191076
Medicare Enrollment ID	O20231101001655

Medical Identifiers

Medical identifiers for such as npi, medicare ID, medicare PIN, medicaid, etc.

Identifier	Type	State	Issuer
1275215972	NPI	-	NPPES

Medical Taxonomies and Licenses

Taxonomy	Type	License (State)	Status
207R00000X	Internal Medicine	(* (Not Available))	Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. acts as a billing entity for following providers:

Provider Name	Oleksandr Seleverstov
Provider Type	Practitioner - Internal Medicine
Provider Identifiers	NPI Number: 1770841421 PECOS PAC ID: 6608162193 Enrollment ID: I20200306002541

Reviews and Comments

Internal Medicine in College Place, WA

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- Medicare Primary Care in College Place, WA