Organization
COLUMBIA BASIN HEALTH ASSOCIATION
Active
Other names
Connell Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
NIEVES GOMEZ (CEO)
(509) 488-5256
Entity
Organization
Contact information
Practice address
1051 S COLUMBIA AVE, CONNELL, WA 99326-8702
(509) 234-0866
(509) 488-9939
Mailing address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(509) 488-9939
Taxonomy
Speciality
Code
Description
License number
State
261Q00000X
Clinic/Center
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0035900
DLI
WA
Enumeration date
10/04/2011
Last updated
05/06/2022
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