Organization
LEWIS COUNTY COMMUNITY HEALTH SERVICES
Active
Other names
Valley View Health Center - Tenino
Organization subpart
No
Provider details
NPI number
Authorized official
MR. STEVEN C CLARK (EXECUTIVE DIRECTOR)
(360) 330-9595
Entity
Organization
Contact information
Practice address
273 SUSSEX AVE E, TENINO, WA 98589-9359
(360) 264-5665
(360) 264-5666
Mailing address
2690 NE KRESKY AVE, CHEHALIS, WA 98532-2412
(360) 330-9595
(360) 330-9560
Taxonomy
Speciality
Code
Description
License number
State
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
602312048
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7126972
—
WA
01
—
G8801670
MEDICARE PART B
WA
Enumeration date
03/15/2017
Last updated
03/15/2017
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