| Organization Name: | LEWIS COUNTY COMMUNITY HEALTH SERVICES |
| NPI Number: | 1689933459 |
| Entity Type Code: | Organizational (2) |
| Authorized Official Name: | STEVEN CLARK (EXECUTIVE DIRECTOR) |
| Mailing Address: | 615 Cemetery Rd Winlock |
| State: | WA US |
| Postal Code: | 985969303 |
| Phone Number: | 3607859400 |
| Fax Number: | 3607850236 |
| NPI Enumeration Date: | 05/14/2012 |
| NPI Last Update Date: | 03/31/2016 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 261QF0400X |
| License Number: | |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | |
| Taxonomy Type: | Ambulatory Health Care Facilities |
| Taxonomy Classification: | Clinic/Center |
| Taxonomy Specialization: | Federally Qualified Health Center (FQHC) |
| Taxonomy Definition: | |