Organization
PUBLIC HOSPITAL DISTRICT #1-A OF WHITMAN COUNTY
Active
Other names
Pullman Regional Hospital
Organization subpart
No
Provider details
NPI number
Authorized official
MATT FORGE CEO (CHIEF EXECUTIVE OFFICER)
(509) 336-7300
Entity
Organization
Contact information
Practice address
835 SE BISHOP BLVD, PULLMAN, WA 99163-5512
(509) 332-2514
(509) 332-0731
Mailing address
835 SE BISHOP BLVD, PULLMAN, WA 99163-5512
(509) 332-2514
(509) 336-7642
Taxonomy
Speciality
Code
Description
License number
State
207PE0004X
Emergency Medical Services (Emergency Medicine) Physician
—
—
247100000X
Radiologic Technologist
—
—
261QC0050X
Critical Access Hospital Clinic/Center
—
—
261QU0200X
Urgent Care Clinic/Center
—
—
282NC0060X
Critical Access Hospital
Primary
H-172
WA
291U00000X
Clinical Medical Laboratory
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003221800
—
ID
05
—
003221990
—
ID
01
—
077
PREMERA BLUE CROSS
WA
01
—
2590
LABOR & INDUSTRIES (FAC)
WA
05
—
3303708
—
WA
05
—
7030661
—
WA
01
—
82105
LABOR & IND. (PHYS GROUP)
WA
Enumeration date
06/13/2005
Last updated
10/22/2025
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