Healthcare Provider Details

I. General information

NPI: 1487679262
Provider Name (Legal Business Name): KITTITAS COUNTY PUBLIC HOSPITAL DISTRICT
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/13/2006
Last Update Date: 07/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

603 S CHESTNUT ST
ELLENSBURG WA
98926
US

IV. Provider business mailing address

603 S CHESTNUT ST
ELLENSBURG WA
98926-3875
US

V. Phone/Fax

Practice location:
  • Phone: 509-962-9841
  • Fax: 509-962-7351
Mailing address:
  • Phone: 509-962-9841
  • Fax: 509-962-7351

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License NumberH-140
License Number StateWA

VIII. Authorized Official

Name: ELIZABETH ALLGOOD
Title or Position: CHIEF FINANCIAL OFFICER
Credential:
Phone: 509-962-7312