Organization
COLUMBIA BASIN HEALTH ASSOCIATION
Active
Other names
Columbia Basin Health Association
Organization subpart
No
Provider details
NPI number
Authorized official
NIEVES GOMEZ (CEO)
(509) 488-5256
Entity
Organization
Contact information
Practice address
475 N 14TH AVE, OTHELLO, WA 99344-1226
(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
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
142749004
—
WA
Enumeration date
05/22/2013
Last updated
11/15/2023
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