NPIMap

Organization Active NPI

Walla Walla General Hospital

Doing business as Adventist Health Medical Group Prosser Clinic

  • Multi-Specialty Clinic/Center
  • Prosser, WA
National Provider Identifier
1376894048
Registry record updated Feb 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
License
363006281 Issued in WA
Legal business name
WALLA WALLA GENERAL HOSPITAL
Doing business as
Adventist Health Medical Group Prosser Clinic
Practice address
336 Chardonnay Ave Ste a
Prosser, WA 99350
Phone
(509) 786-2002
Fax
(509) 786-2026
NPI assigned
Sep 21, 2012
Last updated
Feb 3, 2015By the provider in NPPES
Organization subpart
Yes
Parent organization
WALLA WALLA GENERAL HOSPITALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 3, 2015

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Monty E Knittel
Title
Ceo
Phone
(509) 525-0480

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X 363006281 WA
Multi-Specialty Clinic/Center 261QM1300X 363006281 WA Primary
Rural Health Clinic/Center 261QR1300X

Addresses

Primary practice location

336 Chardonnay Ave Ste a
Prosser, WA 99350

Mailing address

PO Box 1398
Walla Walla, WA 99362-0309
Phone (509) 522-0100

Other names 1

  • Adventist Health Medical Group Prosser Clinic Doing business as

National Provider Directory

National Provider Directory
Part of
Walla Walla Gen Hosp

Locations

1111 S 2nd Ave
Walla Walla, WA 99362
Phone (509) 522-0100

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1348185600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1422921600000",
    "number": "1376894048",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1398",
            "city": "WALLA WALLA",
            "state": "WA",
            "postal_code": "993620309",
            "telephone_number": "509-522-0100",
            "fax_number": "509-527-8010"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "336 CHARDONNAY AVE STE A",
            "city": "PROSSER",
            "state": "WA",
            "postal_code": "99350",
            "telephone_number": "509-786-2002",
            "fax_number": "509-786-2026"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WALLA WALLA GENERAL HOSPITAL",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "WALLA WALLA GENERAL HOSPITAL",
        "enumeration_date": "2012-09-21",
        "last_updated": "2015-02-03",
        "status": "A",
        "authorized_official_last_name": "KNITTEL",
        "authorized_official_first_name": "MONTY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-525-0480"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "WA",
            "license": "363006281",
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "WA",
            "license": "363006281",
            "primary": true
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Adventist Health Medical Group Prosser Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Prosser, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 3, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.