Organization
COLUMBIA BASIN HEALTH ASSOCIATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSHUA BUNCH (CFO)
(509) 488-5250
Entity
Organization
Contact information
Practice address
1051 S COLUMBIA AVENUE, CONNELL, WA 99326
(509) 488-5256
(509) 488-9939
Mailing address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(509) 488-9939
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
—
WA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2000090
—
WA
Enumeration date
06/05/2008
Last updated
09/03/2020
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