Organization
GRANT COUNTY PUBLIC HOSPITAL DISTRICT NO 5
Active
Parent organization
GRANT COUNTY PUBLIC HOSPITAL DISTRICT NO. 5
Other names
Mattawa Community Medical Clinic
Organization subpart
Yes
Provider details
NPI number
Legal business name
GRANT COUNTY PUBLIC HOSPITAL DISTRICT NO. 5
Authorized official
DANA S FOX (CEO)
(509) 932-4499
Entity
Organization
Contact information
Practice address
101 S WILLIAM AVE, MATTAWA, WA 99349-0104
(509) 932-4499
(509) 932-5363
Mailing address
210 GOVERNMENT RD, MATTAWA, WA 99349-5116
(509) 932-4499
(509) 932-5363
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
—
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1699720797
—
WA
Enumeration date
10/29/2019
Last updated
06/04/2025
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