Organization
LEWIS COUNTY COMMUNITY HEALTH SERVICES
Active
Parent organization
LEWIS COUNTY COMMUNITY HEALTH SERVICES
Other names
Valley View Health Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
LEWIS COUNTY COMMUNITY HEALTH SERVICES
Authorized official
GAELON SPRADLEY (CHIEF EXECUTIVE OFFICER)
(360) 330-9555
Entity
Organization
Contact information
Practice address
2690 NE KRESKY AVE, CHEHALIS, WA 98532-2412
(360) 330-9595
(360) 330-9560
Mailing address
2690 NE KRESKY AVE, CHEHALIS, WA 98532-2412
(360) 330-9595
(360) 330-9560
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0208250
DEPARTMENT OF L&I
—
05
—
7126972
—
WA
01
—
9749VA
REGENCE BLUE SHIELD
—
01
—
A001
TRICARE
—
01
—
G8801670
MEDICARE GROUP
WA
Enumeration date
06/18/2006
Last updated
04/05/2023
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