Healthcare Provider Details

I. General information

NPI: 1780881003
Provider Name (Legal Business Name): TRI-CITIES COMMUNITY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/29/2007
Last Update Date: 01/11/2024
Certification Date: 01/11/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

515 W COURT ST
PASCO WA
99301
US

IV. Provider business mailing address

PO BOX 1452
PASCO WA
99301
US

V. Phone/Fax

Practice location:
  • Phone: 509-547-2204
  • Fax: 509-542-8836
Mailing address:
  • Phone: 509-547-2204
  • Fax: 509-542-8836

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: KRISTY NEEDHAM
Title or Position: CEO
Credential:
Phone: 509-547-2204