PACIFIC COUNTY HOSPITAL DISTRICT 2 NPI 1760582522

NPI Information

NPI: 1760582522
Provider Name: PACIFIC COUNTY HOSPITAL DISTRICT 2

Doing Business As: WILLAPA MEDICAL CLINIC

Classification: Clinic/Center - 261QR1300X
Entity Type: Organization

Specialization: Rural Health

Address:
826 ALDER ST
SOUTH BEND, WA
ZIP 98586
Phone: (360) 875-5579
Get Directions

PACIFIC COUNTY HOSPITAL DISTRICT 2 is a rural health clinic center in South Bend, WA. PACIFIC COUNTY HOSPITAL DISTRICT 2 NPI is 1760582522. The provider is registered as an organization entity type and is a single specialty group.
The provider Is Doing Business As Willapa Medical Clinic.

The provider's business location address is:

826 ALDER ST
SOUTH BEND, WA
ZIP 98586-900
Phone: (360) 875-5579
Fax: (360) 875-5235

The provider's authorized official is Mary Mcallister .
The authorized official title is Clinic Manager and has the following contact phone number (360) 875-5579.

The CLIA number assigned to this NPI record is 50D0637268 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 9/22/2006 and was last updated on 10/8/2020.

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	261QR1300X	Clinic/Center	Rural Health			Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1035732	MEDICAID	WASHINGTON
2	9621491	MEDICAID	WASHINGTON
3	0317075	OTHER	WASHINGTON	LABOR & INDUSTRIES-DR. BUBEN
4	GAB11482	OTHER	WASHINGTON	RENDERING PIN BUBEN
5	0317062	OTHER	WASHINGTON	LABOR & INDUSTRIES-PFHC
6	0317067	OTHER	WASHINGTON	LABOR & INDUSTRIES-JARED ABRAMS

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: 5/5/2024

NPI Synchronization or Removal

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