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Organization

FAMILY HEALTH CENTERS

Active
Other names
OKANOGAN FARM WORKERS CLINIC
Organization subpart
No

Provider details

NPI number
Authorized official
MR. JESUS HERNANDEZ (INTERM CEO)
(509) 422-7601
Entity
Organization

Contact information

Practice address
716 FIRST AVENUE SOUTH, OKANOGAN, WA 98840-9679
(509) 422-5700
(509) 422-7680
Mailing address
PO BOX 1340, OKANOGAN, WA 98840-1340
(509) 422-5700
(509) 422-7680

Taxonomy

Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
600625131
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1184883449
MEDICARE
WA
01
1306005715
MEDICARE
WA
01
1497176390
MEDICARE
WA
01
1609804392
MEDICARE
WA
01
1629237482
MEDICARE
WA
01
1821340092
MEDICARE
WA
01
501836
PTAN
WA
01
501837
PTAN
WA
01
501949
MEDICARE PTAN
WA
01
501968
MEDICARE PTAN
WA
05
7060643
WA
01
801838
PTAN
WA
01
C03341
MEDICARE PTAN
WA
01
G000354600
MEDICARE PTAN
WA
Enumeration date
06/29/2006
Last updated
01/19/2021
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