Organization
LEWIS COUNTY COMMUNITY HEALTH SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
STEVEN C. CLARK (EXECUTIVE DIRECTOR)
(360) 330-9595
Entity
Organization
Contact information
Practice address
711 HARRISON AVE, CENTRALIA, WA 98531-2109
(360) 736-5405
(360) 736-5620
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
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7126972
—
WA
Enumeration date
08/16/2018
Last updated
08/16/2018
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