Organization
KLICKITAT COUNTY PUBLIC HOSPITAL DISTRICT NO 1
Active
Other names
KVH FAMILY MEDICINE
Organization subpart
No
Provider details
NPI number
Authorized official
LESLIE HIEBERT (CEO)
(509) 773-4022
Entity
Organization
Contact information
Practice address
317 SANDERS WAY, GOLDENDALE, WA 98620-9053
(509) 773-4022
Mailing address
310 S ROOSEVELT AVE, GOLDENDALE, WA 98620-9201
(509) 773-4022
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
202000768
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7076862
—
WA
Enumeration date
11/01/2006
Last updated
03/20/2015
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