Provider Demographics
NPI:1013943778
Name:WALLA WALLA GENERAL HOSPITAL
Entity Type:Organization
Organization Name:WALLA WALLA GENERAL HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRES.
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:EUGENE
Authorized Official - Last Name:LENHART
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:509-525-1800
Mailing Address - Street 1:1017 S 2ND AVE
Mailing Address - Street 2:2
Mailing Address - City:WALLA WALLA
Mailing Address - State:WA
Mailing Address - Zip Code:99362-4183
Mailing Address - Country:US
Mailing Address - Phone:509-525-1800
Mailing Address - Fax:509-525-1800
Practice Address - Street 1:1017 S 2ND AVE
Practice Address - Street 2:
Practice Address - City:WALLA WALLA
Practice Address - State:WA
Practice Address - Zip Code:99362-4183
Practice Address - Country:US
Practice Address - Phone:509-525-1800
Practice Address - Fax:509-525-1800
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-24
Last Update Date:2013-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2082S0105XAllopathic & Osteopathic PhysiciansPlastic SurgerySurgery of the HandGroup - Single Specialty
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKK160715Medicare PIN