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 provides Neurological Surgery Physician services 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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