| Organization Name: | KLICKITAT COUNTY PUBLIC HOSPITAL DISTRICT NO 1 |
| NPI Number: | 1386689487 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | LESLIE HIEBERT (CEO) |
| Mailing Address: | 310 S Roosevelt Ave Goldendale |
| State: | WA US |
| Postal Code: | 986209201 |
| Phone Number: | 5097734022 |
| Fax Number: | |
| NPI Enumeration Date: | 06/20/2006 |
| NPI Last Update Date: | 10/24/2014 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QX0100X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Occupational Medicine |
| Taxonomy Definition: | |