Healthcare Provider Details

I. General information

NPI: 1407916141
Provider Name (Legal Business Name): COUNTY OF ADAMS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/11/2006
Last Update Date: 12/17/2019
Certification Date: 12/17/2019
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 E MAIN ST STE 700
OTHELLO WA
99344-1146
US

IV. Provider business mailing address

425 E MAIN ST STE 700
OTHELLO WA
99344-1146
US

V. Phone/Fax

Practice location:
  • Phone: 509-488-2031
  • Fax: 509-331-0030
Mailing address:
  • Phone: 509-488-2031
  • Fax: 509-331-0030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: VICKI GUSE
Title or Position: ADMINISTRATOR
Credential:
Phone: 509-488-4074