Healthcare Provider Details

I. General information

NPI: 1932286077
Provider Name (Legal Business Name): COLUMBIA COUNTY HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 04/26/2022
Certification Date: 04/26/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1012 SOUTH THIRD STREET
DAYTON WA
99328
US

IV. Provider business mailing address

1012 SOUTH THIRD STREET
DAYTON WA
99328
US

V. Phone/Fax

Practice location:
  • Phone: 509-382-2531
  • Fax: 509-382-3205
Mailing address:
  • Phone: 509-382-2531
  • Fax: 509-382-3205

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code275N00000X
TaxonomyMedicare Defined Swing Bed Hospital Unit
License NumberH141
License Number StateWA

VIII. Authorized Official

Name: MR. MATT MINOR
Title or Position: CFO
Credential:
Phone: 509-382-2531