# LAKE ROOSEVELT COMMUNITY HEALTH CENTERS

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Colville Nations Community Health Center
- **Organization subpart:** No

## Provider details

- **NPI number:** 1073776936
- **Authorized official:** MR. BILL FOXCROFT (EXECUTIVE DIRECTOR)
- **Authorized official phone:** (509) 722-7610

## Contact information

- **Practice address:** 39 SHORT CUT ROAD, INCHELIUM, WA 99138-0290
- **Practice address phone:** (509) 722-7610
- **Mailing address:** 39 SHORT CUT ROAD, PO BOX 290, INCHELIUM, WA 99138-0290
- **Mailing address phone:** (509) 722-7610

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 207Q00000X | Family Medicine Physician | — | NULL | Yes |
| 207Q00000X | Family Medicine Physician | — | — | Yes |

## Other

- **Enumeration date:** 07/09/2008
- **Last updated:** 07/09/2008