OrganizationActive
Seleverstov Medical, P.C.
NPI 1275215972 · Internal Medicine Physician · College Place, WA
Provider details
- NPI number
- 1275215972
- Entity type
- Organization
- Primary specialty
- Internal Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Oleksandr Seleverstov, Owner(518) 801-6446
Specialties & taxonomies
Allopathic & Osteopathic Physicians
Profile Score
Established profile(58/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
2 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
56 N College Ave Unit 2a
College Place, WA 99324-1048
Phone: (097) 300-7285
Fax: (866) 531-7606
Street-level locationGet directions
Mailing address
146 Thunder Ridge Dr
Walla Walla, WA 99362-7762
Other names (DBA / former)
- Doing business as
- Heritage Clinic
- Doing business as
- Heritage Clinic
Registry dates
- Enumerated
- 2023-08-02
- Last updated
- 2025-01-29
- Certified
- 2025-01-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.