Healthcare Provider Details

I. General information

NPI: 1306897681
Provider Name (Legal Business Name): PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 PROSSER HEALTH DR
PROSSER WA
99350-7832
US

IV. Provider business mailing address

PO BOX 84112
SEATTLE WA
98124-5412
US

V. Phone/Fax

Practice location:
  • Phone: 509-786-2222
  • Fax: 509-788-6013
Mailing address:
  • Phone: 509-786-2222
  • Fax: 509-786-6612

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QC0050X
TaxonomyCritical Access Hospital Clinic/Center
License Number000056
License Number StateWA
# 2
Primary TaxonomyN
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License Number000056
License Number StateWA
# 3
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License NumberHAC.FS.00000046
License Number StateWA

VIII. Authorized Official

Name: CRAIG MARKS
Title or Position: CEO
Credential:
Phone: 509-786-2222