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

Providence Health & Services - Washington

Organization Neurological Surgery Physician · NPI 1760636690

Providence Health & Services - Washington is a Neurological Surgery Physician in Walla Walla, Washington. Licensed in Washington. Registered with an NPI since 2008.

Licensed in
WA
In the registry since
2008

Practice location Address checks out

301 W Poplar St Ste 50
Walla Walla, WA 99362-2800
Phone: (509) 522-1030
Fax: (509) 526-8402
Show map & directions

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

Specialties & licences

Neurological Surgery Physician (primary) Taxonomy 207T00000X · Licence H-050 (WA)

Record details

NPI number1760636690
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationProvidence Health & Services - Washington
Authorized official Donald Anderson — Assistant Secretary Of Enrollments · (425) 358-9786
Other names Providence Medical Group Southeast Washington Neurosurgery
NPI enumeratedNovember 5, 2008
Last updated in NPPESMay 7, 2025
Certification dateMay 7, 2025
Mailing addressPo Box 31001-4114, Pasadena, CA 91110-4114

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