PRIVIA MEDICAL GROUP WASHINGTON PLLC NPI 1467715847

NPI Information

NPI: 1467715847
Provider Name: PRIVIA MEDICAL GROUP WASHINGTON, PLLC

Doing Business As: WALLA WALLA CLINIC

Classification: Nurse Practitioner - 363LF0000X
Entity Type: Organization

Specialization: Family

Address:
55 W TIETAN ST
WALLA WALLA, WA
ZIP 99362
Phone: (509) 525-3720
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PRIVIA MEDICAL GROUP WASHINGTON, PLLC is a family nurse practitioner in Walla Walla, WA. PRIVIA MEDICAL GROUP WASHINGTON, PLLC NPI is 1467715847. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Walla Walla Clinic.

The provider's business location address is:

55 W TIETAN ST
WALLA WALLA, WA
ZIP 99362-445
Phone: (509) 525-3720
Fax: (509) 522-1593

The provider's authorized official is Kevin J Michelson .
The authorized official title is Ceo and has the following contact phone number (509) 525-3720.

The enumeration date for this NPI number is 6/20/2012 and was last updated on 10/6/2023.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LF0000X	Nurse Practitioner	Family	AP60297383	WASHINGTON	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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