Heritage Clinic in Walla Walla, WA - Medicare Internal Medicine

Heritage Clinic is a medicare enrolled primary clinic (Internal Medicine) in Walla Walla, Washington. The current practice location for Heritage Clinic is 1129 S 2nd Ave Ste B, Walla Walla, Washington. For appointments, you can reach them via phone at (509) 520-5520. The mailing address for Heritage Clinic is 146 Thunder Ridge Dr, Walla Walla, Washington and phone number is (518) 801-6446.

Heritage Clinic 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 (509) 520-5520.

Contact Information

	Heritage Clinic
	1129 S 2nd Ave Ste B Walla Walla WA 99362-4100
	(509) 520-5520
	Not Available

Map and Direction

Primary Care Clinic Profile

Full Name	Heritage Clinic
Speciality	Internal Medicine
Location	1129 S 2nd Ave Ste B, Walla Walla, 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
Heritage Clinic 146 Thunder Ridge Dr Walla Walla WA 99362-7762 Ph: (518) 801-6446	Heritage Clinic 1129 S 2nd Ave Ste B Walla Walla WA 99362-4100 Ph: (509) 520-5520

NPI Details:

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

Medicare PECOS Information:

Medicare PECOS PAC ID	5395191076
Medicare Enrollment ID	O20231101001655

Medical Identifiers

Medical identifiers for Heritage Clinic 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. Heritage Clinic 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

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Heritage Clinic - Medicare Primary Care in Walla Walla, WA