Healthcare Provider Details

I. General information

NPI: 1477128585
Provider Name (Legal Business Name): FAMILY HEALTH CENTERS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/21/2021
Last Update Date: 05/05/2026
Certification Date: 05/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1003 KOALA DR
OMAK WA
98841-9247
US

IV. Provider business mailing address

PO BOX 1340
OKANOGAN WA
98840-1340
US

V. Phone/Fax

Practice location:
  • Phone: 509-422-7674
  • Fax:
Mailing address:
  • Phone: 509-422-7674
  • Fax: 509-422-7668

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QF0400X
TaxonomyFederally Qualified Health Center (FQHC)
License Number
License Number State

VIII. Authorized Official

Name: MR. JESUS HERNANDEZ
Title or Position: CEO
Credential:
Phone: 509-422-7601