Organization
COMMUNITY HEALTH OF CENTRAL WASHINGTON
Active
Other names
Ellensburg Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
ANGELA GONZALEZ (CEO)
(509) 494-6700
Entity
Organization
Contact information
Practice address
521 E MOUNTAIN VIEW AVE, ELLENSBURG, WA 98926-3865
(509) 933-4800
(509) 933-4802
Mailing address
501 S 5TH AVE, YAKIMA, WA 98902-3550
(509) 494-6700
(509) 573-6275
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
—
—
261QD0000X
Dental Clinic/Center
Primary
—
—
261QF0400X
Federally Qualified Health Center (FQHC)
—
—
261QS1000X
Student Health Clinic/Center
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7118276
—
WA
Enumeration date
10/02/2009
Last updated
10/11/2023
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