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

Providence Health & Services - Washington

Organization Emergency Medicine Physician · NPI 1699926402

Providence Health & Services - Washington is an Emergency Medicine Physician in Walla Walla, Washington. Licensed in Washington. Registered with an NPI since 2008.

Licensed in
WA
In the registry since
2008
Specialties on file
3

Practice location Address checks out

401 W Poplar St
Walla Walla, WA 99362-2846
Phone: (509) 522-5802
Fax: (509) 522-5541
Show map & directions

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

Specialties & licences

Emergency Medicine Physician (primary) Taxonomy 207P00000X · Licence H-050 (WA)
Internal Medicine Physician Taxonomy 207R00000X
General Acute Care Hospital Taxonomy 282N00000X

Record details

NPI number1699926402
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Providence St Mary Med Ctr Er; Providence St Mary Med Ctr Er
NPI enumeratedOctober 10, 2008
Last updated in NPPESMay 7, 2025
Certification dateMay 7, 2025
Mailing addressPo Box 31001-4114, Pasadena, CA 91110-4114

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