Pullman Regional Hospital – Family Medicine Physician, NPI 1881475051
Family Medicine Physician
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for Pullman Regional Hospital
1620 SE Summit Ct
Pullman, WA 991635540
Phone: (509) 332-5106
Fax: (509) 334-5723
Type: Location
825 SE Bishop Blvd Ste 130
Pullman, WA 991635517
Phone: (509) 338-0632
Fax: (509) 715-2130
Type: Location
825 SE Bishop Blvd Ste 140
Pullman, WA 991635517
Phone: (509) 334-4498
Fax: (509) 715-2132
Type: Location
305 E Main St
Ste 102
Palouse, WA 99161
Phone: (509) 878-1890
Fax: (509) 715-2125
Type: Location
915 NE Valley Rd
Pullman, WA 991633845
Phone: (509) 332-3548
Fax: (509) 715-2124
Type: Location
825 SE Bishop Blvd Ste 101
Pullman, WA 991635517
Phone: (509) 332-3499
Fax: (509) 715-2129
Type: Location
1205 SE Professional Mall Blvd Ste 104
Pullman, WA 991635423
Phone: (509) 332-2605
Fax: (509) 715-2123
Type: Location
825 SE Bishop Blvd Ste 120
Pullman, WA 991635517
Phone: (509) 332-2828
Fax: (509) 334-7474
Type: Location
825 SE Bishop Blvd Ste 401
Pullman, WA 991635517
Phone: (509) 336-7720
Fax: (509) 715-2131
Type: Location
825 SE Bishop Blvd Ste 201
Pullman, WA 991635517
Phone: (509) 336-7577
Fax: (509) 715-2126
Type: Location
405 NE Stadium Way
Pullman, WA 991633825
Phone: (509) 338-0650
Fax: (509) 338-0654
Type: Location
2500 W A St Ste 201
Moscow, ID 838436000
Phone: (208) 883-2828
Fax: (208) 882-2179
Type: Location
1420 S Blaine St Ste 5
Moscow, ID 838433973
Phone: (208) 882-2247
Fax: (509) 715-2123
Type: Location
840 SE BISHOP BLVD STE 103
PULLMAN, WA 991635502
Phone: (509) 336-7609
Fax: (509) 524-8410
Type: Mailing
835 SE BISHOP BLVD
PULLMAN, WA 991635512
Phone: (509) 336-7300
Type: Location
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.
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20040223000506 | O | Clinic/Group Practice | WA | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
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 99163)
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Reviews
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