NPIMap

Individual provider Active NPI

Selemani E Wambuzi, PA-C

  • Medical Physician Assistant
  • Mattawa, WA
National Provider Identifier
1659921302
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
PA61127469 Issued in WA
Practice address
601 Government Rd
Mattawa, WA 99349-5120
Phone
(509) 488-5256
Fax
(509) 488-9939
NPI assigned
Sep 16, 2019
Last updated
Apr 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X PA61127469 WA Primary
Family Medicine Physician 207Q00000X ML70088355 WA

Addresses

Primary practice location

601 Government Rd
Mattawa, WA 99349-5120

Mailing address

1515 E Columbia St
Othello, WA 99344-1846
Phone (509) 488-5256

Other practice location 1

1515 E Columbia St
Othello, WA 99344-1846
Phone (509) 488-5256 ext. 8512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210401000191 WA Practitioner - Physician Assistant 8224445630 Reassigns benefits to 6 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Douglas, Grant, Lincoln and Okanogan Counties Public Hospital DistrictGroup PAC ID 9335050285, shared by 5 NPIs, 40 clinicians

Practice addresses (Care Compare)

200 Nat Washington Way
Ephrata, WA 98823-1982

200 Nat Washington Way
Columbia Basin Hospital
Ephrata, WA 98823-1997
Phone (509) 754-4631

220 Nat Washington Way
Ephrata, WA 98823-1982

411 Fortuyn Rd
Grand Coulee, WA 99133-8718
Phone (509) 633-1753

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
ML70088355WAMDFamily Medicine Physician
PA61127469WAMDMedical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Grant County Public Hospital District 3 CurrentSince Oct 1, 2023 Accepting new patients
Columbia Basin Health Association Family Medicine CurrentSince Feb 2, 2026 Accepting new patients
Grant Co Public Hospital District 3 CurrentSince Aug 1, 2025 Accepting new patients
Columbia Basin Health Association CurrentSince Feb 2, 2026 Accepting new patients
Grant County Public Hospital District No. 3 Family Medicine CurrentSince Aug 1, 2025 Accepting new patients
Adams County Public Hospital District 3 CurrentSince Dec 9, 2025 Accepting new patients
Grant County Public Hospital District No. 3 Past Accepting new patients

Locations

200 Nat Washington Way
Ephrata, WA 98823
Phone (509) 754-3330

220 Nat Washington Way
Ephrata, WA 98823
Phone (509) 754-3330

601 Government Rd
Mattawa, WA 99349
Phone (509) 234-0866

1515 E Columbia St
Othello, WA 99344
Phone (509) 488-5250

315 N 14th Ave
Othello, WA 99344
Phone (509) 331-2667

7405 Three Rivers Dr
Pasco, WA 99301
Phone 5094885256 ext. 8512

Organizations & group practices 10

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1568592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1659921302",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1515 E COLUMBIA ST",
            "city": "OTHELLO",
            "state": "WA",
            "postal_code": "993441846",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 GOVERNMENT RD",
            "city": "MATTAWA",
            "state": "WA",
            "postal_code": "993495120",
            "telephone_number": "509-488-5256",
            "fax_number": "509-488-9939"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1515 E Columbia St",
            "address_purpose": "LOCATION",
            "city": "Othello",
            "state": "WA",
            "postal_code": "993441846",
            "country_code": "US",
            "telephone_number": "509-488-5256 x8512",
            "fax_number": "509-488-9939",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WAMBUZI",
        "first_name": "SELEMANI",
        "middle_name": "E",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-16",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "WA",
            "license": "PA61127469",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WA",
            "license": "ML70088355",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mattawa, WA

Sources for this page

Verify at the official NPI Registry.