Organization
KITTITAS COUNTY PUBLIC HOSPITAL DIST 1
Active
Other names
KVH General Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
LISA GOTT (REVENUE CYCLE DIRECTOR OPERATION)
(509) 962-7424
Entity
Organization
Contact information
Practice address
603 S CHESTNUT ST, ELLENSBURG, WA 98926-3875
(509) 962-7390
Mailing address
PO BOX 799, ELLENSBURG, WA 98926-1921
(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
07/29/2026
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