Organization
NEW HEALTH PROGRAM ASSOCIATION
Active
Other names
NEW Health Colville Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DONNA POE (CREDENTIALING SPECIALIST)
(509) 935-6001
Entity
Organization
Contact information
Practice address
161 E 3RD AVE, COLVILLE, WA 99114-2310
(509) 684-1440
(509) 684-1277
Mailing address
PO BOX 808, CHEWELAH, WA 99109-0808
(509) 935-6001
(509) 935-4196
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
J600317870
WA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5024922
—
WA
01
—
80300
LABOR AND INDUSTRIES ID
WA
Enumeration date
04/13/2006
Last updated
07/18/2023
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