Organization
NEW HEALTH PROGRAM ASSOCIATION
Active
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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