Organization
COLUMBIA BASIN HEALTH ASSOCIATION
Active
Parent organization
COLUMBIA BASIN HEALTH ASSOCIATION
Other names
Othello Dental Center
Organization subpart
Yes
Provider details
NPI number
Legal business name
COLUMBIA BASIN HEALTH ASSOCIATION
Authorized official
JOSHUA BUNCH (CFO)
(509) 488-5250
Entity
Organization
Contact information
Practice address
1515 E COLUMBIA ST, OTHELLO, WA 99344-1846
(509) 488-5256
(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
261QD0000X
Dental Clinic/Center
—
WA
261QF0400X
Federally Qualified Health Center (FQHC)
Primary
—
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0134585
DEPT L&I #
WA
05
—
1021671
—
WA
01
—
8923240
CRIME VICTIMS #
WA
Enumeration date
04/23/2007
Last updated
09/03/2020
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