Organization
LINCOLN COUNTY HOSPITAL DISTRICT 3
Active
Organization
LINCOLN COUNTY HOSPITAL DISTRICT 3
Active
Parent organization
LINCOLN COUNTY HOSPITAL DISTRICT #3
Other names
North Basin Medical Clinics--Davenport Clinic, Davenport Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
LINCOLN COUNTY HOSPITAL DISTRICT #3
Authorized official
TYSON LACY (CEO)
(509) 725-2979
Entity
Organization
Contact information
Practice address
10 NICHOLLS ST, DAVENPORT, WA 99122-9729
(509) 725-7501
(509) 725-7504
Mailing address
10 NICHOLLS ST, DAVENPORT, WA 99122-9729
(509) 725-7501
(509) 725-7504
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
H-137
WA
208600000X
Surgery Physician
H-137
WA
261QR1300X
Rural Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7101132
—
WA
05
—
7117450
—
WA
01
—
CJ6525
MEDICARE RAILROAD
WA
Enumeration date
06/03/2006
Last updated
06/08/2026
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