Healthcare Provider Details

I. General information

NPI: 1457526139
Provider Name (Legal Business Name): OKANOGAN DOUGLAS DISTRICT HOSPITAL
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/24/2008
Last Update Date: 04/24/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

507 HOSPITAL WAY
BREWSTER WA
98812-0577
US

IV. Provider business mailing address

507 HOSPITAL WAY PO BOX 577
BREWSTER WA
98812-0577
US

V. Phone/Fax

Practice location:
  • Phone: 509-689-2517
  • Fax: 509-689-2086
Mailing address:
  • Phone: 509-689-2517
  • Fax: 509-689-2086

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License NumberH23
License Number StateWA

VIII. Authorized Official

Name: MRS. JENNIFER MUNSON
Title or Position: CFO
Credential:
Phone: 509-689-2517