Wallowa Memorial Medical Clinic - Wallowa – Rural Health Clinic/Center, NPI 1508452160

Wallowa Memorial Medical Clinic - Wallowa is a healthcare provider. based in Wallowa, Oregon. specializing in Rural Health Clinic/Center. The NPI Number for Wallowa Memorial Medical Clinic - Wallowa is 1508452160

Main info

Organization
Name
Wallowa Memorial Medical Clinic - Wallowa
NPI
1508452160
Phone
(541) 426-7900
Address
211 EAST 2ND ST
Authorized Official
JOSEPH WANNER CFO
Enumeration Date
17 December 2020
Last Update Date
31 January 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness80
Years active:5State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Wallowa Memorial Medical Clinic - Wallowa

  • 211 EAST 2ND ST

    WALLOWA, OR 97885

    Phone: (541) 426-7900

    Type: Location

  • 601 MEDICAL PKWY

    ENTERPRISE, OR 978285124

    Phone: (541) 426-5460

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2021-02-03

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Revalidation due soon

Earliest CMS due date is 2026-07-31 (52 days away).

Enrollment records

1

Earliest due date

2026-07-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20210203002888ORural Health ClinicOR2026-07-31

What to do next

  • Confirm the due date on the CMS Revalidation Lookup Tool.
  • Complete revalidation in PECOS before the published due date.
  • If you have multiple enrollment records, revalidate each one on its own schedule.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 97885)

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Reviews

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Frequently asked questions

What is the 10-digit NPI for Wallowa Memorial Medical Clinic - Wallowa?
Wallowa Memorial Medical Clinic - Wallowa — NPI 1508452160 — is the standard way to identify this listing.
Does CMS list Wallowa Memorial Medical Clinic - Wallowa as active?
Yes — Wallowa Memorial Medical Clinic - Wallowa is active in the NPI listing used on this page.
What is Wallowa Memorial Medical Clinic - Wallowa best known for clinically?
Directory data describes Wallowa Memorial Medical Clinic - Wallowa with Rural Health Clinic/Center. Clinical services aligned with this taxonomy classification.
Where is Wallowa Memorial Medical Clinic - Wallowa based?
Wallowa Memorial Medical Clinic - Wallowa is tied to Wallowa, Oregon in the data we show; additional addresses may exist on the full record.
Is specialty guaranteed by NPI alone?
Taxonomy selections describe intent; scope of practice still follows state law.

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