Healthcare Provider Details

I. General information

NPI: 1275692147
Provider Name (Legal Business Name): WAHKIAKUM COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/07/2006
Last Update Date: 03/13/2023
Certification Date: 03/13/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

42 ELOCHOMAN VALLEY RD
CATHLAMET WA
98612-9602
US

IV. Provider business mailing address

PO BOX 696
CATHLAMET WA
98612
US

V. Phone/Fax

Practice location:
  • Phone: 360-795-6207
  • Fax: 360-795-6143
Mailing address:
  • Phone: 360-795-6207
  • Fax: 360-795-6143

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License NumberMD00025787
License Number StateWA

VIII. Authorized Official

Name: MR. CHRIS A BISCHOFF
Title or Position: WAHKIAKUM COUNTY HHS DIRECTOR
Credential: MSML, RS/REHS
Phone: 360-795-6207