Organization Name: | COLUMBIA BASIN HEALTH ASSOCIATION |
NPI Number: | 1427494004 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | KENT MOSBRUCKER (CFO) |
Mailing Address: | 475 N 14th Ave Othello |
State: | WA US |
Postal Code: | 993441226 |
Phone Number: | 5094886644 |
Fax Number: | 5094889939 |
NPI Enumeration Date: | 05/22/2013 |
NPI Last Update Date: | 05/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | WA |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |