Organization
KITTITAS COUNTY PUBLIC HOSP DIST 1
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JULIE PETERSEN (INTERIM CEO)
(509) 962-7301
Entity
Organization
Contact information
Practice address
603 S CHESTNUT ST, ELLENSBURG, WA 98926
(509) 925-8484
(509) 925-8485
Mailing address
603 S CHESTNUT ST, ELLENSBURG, WA 98926-3875
(509) 925-8484
(509) 925-8485
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
PHAR.CF.60588203
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2077649
—
WA
01
—
2165866
PK
—
Enumeration date
02/13/2017
Last updated
06/01/2018
Update your record
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