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GRANT COUNTY PUBLIC HOSPITAL DISTRICT 5 NPI 1699720797

NPI Profile

NPI: 1699720797

Provider Name: GRANT COUNTY PUBLIC HOSPITAL DISTRICT 5

Doing Business As: MATTAWA COMMUNITY MEDICAL CLINIC

Classification: Clinic/Center - 261QF0400X

Entity Type: Organization

Specialization: Federally Qualified Health Center (FQHC)

Address:
210 GOVERNMENT ROAD
MATTAWA, WA
ZIP 99349

Phone: (509) 932-4499

GRANT COUNTY PUBLIC HOSPITAL DISTRICT 5 is a federally qualified health center (fqhc) cliniccenter in Mattawa, WA. GRANT COUNTY PUBLIC HOSPITAL DISTRICT 5 NPI is 1699720797. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Is Doing Business As Mattawa Community Medical Clinic.

The provider's business location address is:

210 GOVERNMENT ROAD
MATTAWA, WA
ZIP 99349-960
Phone: (509) 932-4499
Fax: (509) 932-5363

The provider's authorized official is Dana S Fox .
The authorized official title is Ceo/executive Director and has the following contact phone number (509) 932-4499.

The enumeration date for this NPI number is 5/24/2006 and was last updated on 11/4/2015.

Map - Location of Practice

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 207Q00000X Family Medicine No
2 363L00000X Nurse Practitioner No
3 261QF0400X Clinic/Center Federally Qualified Health Center (FQHC) WASHINGTON Yes

What is NPI?
NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 9/10/2017