Organization
FAMILY HEALTH CENTERS
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JESUS HERNANDEZ (CEO)
(509) 422-7601
Entity
Organization
Contact information
Practice address
626 2ND AVE S, OKANOGAN, WA 98840
(509) 422-6705
Mailing address
PO BOX 1340, OKANOGAN, WA 98840-1340
(509) 422-8632
(509) 422-8632
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
—
—
1223D0001X
Public Health Dentistry
—
—
1223G0001X
General Practice Dentistry
Primary
—
—
1223P0221X
Pediatric Dentistry
—
—
1223X0008X
Oral and Maxillofacial Radiology Dentistry
—
—
124Q00000X
Dental Hygienist
—
—
261QD0000X
Dental Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7060643
—
WA
Enumeration date
07/16/2019
Last updated
05/05/2026
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