Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Providence Health & Services - Washington

Organization Urology Physician · NPI 1417191057

Providence Health & Services - Washington is an Urology Physician in Walla Walla, Washington. Licensed in Washington. Registered with an NPI since 2009.

Licensed in
WA
In the registry since
2009

Practice location Address checks out

301 W Poplar St Ste 50
Walla Walla, WA 99362-2858
Phone: (509) 522-5832
Fax: (509) 522-5516
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Urology Physician (primary) Taxonomy 208800000X · Licence HAC.FS.00000050 (WA)

Record details

NPI number1417191057
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Providence Smmc Urology Dme
NPI enumeratedApril 27, 2009
Last updated in NPPESMarch 6, 2026
Certification dateMarch 6, 2026
Mailing addressPo Box 31001 - 4110, Pasadena, CA 91110-4110

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