Organization
KITTITAS COUNTY PUBLIC HOSPITAL DIST 1
Active
Other names
KVH General Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
BECKY L LITTKE (REVENUE CYCLE DIRECTOR)
(509) 962-7424
Entity
Organization
Contact information
Practice address
611 S CHESTNUT ST STE A, ELLENSBURG, WA 98926-4815
(509) 962-7390
Mailing address
P.O. BOX 799, ELLENSBURG, WA 98926
(509) 962-7390
(509) 925-6948
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
000036
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
G000319179
MEDICARE PTAN
WA
Enumeration date
05/15/2009
Last updated
06/11/2020
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