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

Douglas Edison West, PAC

Individual provider Physician Assistant · NPI 1104884295

Douglas Edison West, PAC is a Physician Assistant in Walla Walla, Washington. Qualified in 1993, 33 years ago. Practices with Providence Health and Services Washington, a 776-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Washington.

Years since qualifying
33
Licensed in
WA
In the registry since
2006
What do these letters mean?
PAC — Physician Assistant, Certified
A physician assistant holding current national certification; usually written PA-C.

See every abbreviation used in this directory →

Practice location Address checks out

301 W Poplar St Ste 220
Walla Walla, WA 99362-2858
Phone: (509) 522-1030
Fax: (509) 529-6066
Show map & directions

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

Additional practice locations (1)

  • 101 W 8th Ave, Spokane, WA 99204-2307 — (509) 459-3583

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence PA10003131 (WA)

Record details

NPI number1104884295
Entity typeIndividual (Type 1)
GenderMale
Credentials PAC
Sole proprietorNo
NPI enumeratedMay 1, 2006
Last updated in NPPESMarch 1, 2021
Certification dateMarch 1, 2021
Mailing addressPo Box 32, Liberty Lake, WA 99019-0032

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 1993 (33 years in practice)
Group practice Providence Health And Services Washington — 776 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations3 on file with Medicare

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