Organization
GRANT CO PUBLIC HOSPITAL DISTRICT 3
Active
Other names
Columbia Basin Family Medicine Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
ROSALINDA KIBBY CPCS (EXECUTIVE ASSISTANT)
(509) 754-4631
Entity
Organization
Contact information
Practice address
220 NAT WASHINGTON WAY, EPHRATA, WA 98823-1982
(509) 754-3330
(509) 754-2351
Mailing address
220 NAT WASHINGTON WAY, EPHRATA, WA 98823-1982
(509) 754-3330
(509) 754-2351
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0073230
L & I
WA
01
—
503985
MEDICARE ID TYPE UNSPECIFIED
WA
05
—
7105331
—
WA
01
—
8918013
L & I CRIME VICTIMS
WA
01
—
CO0198
REGENCE
WA
01
—
CO07813
MEDICARE RAILROAD
WA
Enumeration date
12/18/2006
Last updated
12/07/2016
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