Family Medicine
PROVIDENCE HEALTH & SERVICES - WASHINGTON
Identity confirmed via CMS NPPES · September 30, 2026 · A directory match is not a coverage approval.
Is this your practice? This listing was imported from public provider identity data (CMS NPPES) and has not yet been claimed. Claim this listing to confirm the practice details. Plan acceptance stays unpublished until the practice reports it.
Public record
NPI 1922259738 · enumerated 2008-10-10 · record updated 2026-02-17. Source: CMS NPPES. A listing is not a TRICARE network approval.
NPPES recordGoogle Maps Apple Maps OpenStreetMap
Authorized official: DONALD ANDERSON, ASSISTANT SECRETARY OF ENROLLMENTS · (425) 358-9786
Other names: PROVIDENCE MEDICAL GROUP SOUTHEAST WASHINGTON
Addresses and phones
- Mailing address PO BOX 31001-4114, PASADENA, CA, 91110-4114 (509) 529-8905 Fax (509) 526-8402 Google Maps Apple Maps OpenStreetMap
- Practice location 380 CHASE AVENUE, PMG SE WA, WALLA WALLA, WA, 99362-2924 (509) 526-3333 Fax (509) 526-8402 Google Maps Apple Maps OpenStreetMap
Specialties
- Orthotic Fitter 225000000X
- Surgery 208600000X · License H-050 WA
- Internal Medicine 207R00000X · License H-050 WA
- Physical Therapist 225100000X
- Social Worker, Clinical 1041C0700X
- Orthopaedic Surgery 207X00000X · License H-050 WA
- Family Medicine 207Q00000X · Primary · License H-050 WA
In this directory
Locations and evidence
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Practice location
WALLA WALLA, WA, 993622924
Accepting new patientsNot reportedCMS NPPES · September 30, 2026
Plan acceptance
- No published plan acceptance yet. Confirm directly with the practice, or claim this listing if it's yours.