Healthcare Provider Details

I. General information

NPI: 1689722472
Provider Name (Legal Business Name): DOUGLAS,GRANT, LINCOLN AND OKANOGAN COUNTIES HOSPITAL DISTRICT #6
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/08/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

130 N ADAMS
COULEE CITY WA
99115
US

IV. Provider business mailing address

411 FORTUYN RD
GRAND COULEE WA
99133-8718
US

V. Phone/Fax

Practice location:
  • Phone: 509-632-5776
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QC1500X
TaxonomyCommunity Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: MS. JULIE D PARRISH
Title or Position: CREDENTIALING COORDINATOR
Credential:
Phone: 509-633-6388