Healthcare Provider Details

I. General information

NPI: 1508899816
Provider Name (Legal Business Name): FERRY COUNTY PUBLIC HOSPITAL DISTRICT NO 1
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/09/2006
Last Update Date: 07/21/2025
Certification Date: 07/21/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

36 KLONDIKE RD
REPUBLIC WA
99166-9701
US

IV. Provider business mailing address

36 KLONDIKE RD
REPUBLIC WA
99166-9701
US

V. Phone/Fax

Practice location:
  • Phone: 509-775-3333
  • Fax: 509-775-3866
Mailing address:
  • Phone: 509-775-3333
  • Fax: 509-775-3866

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code3416L0300X
TaxonomyLand Ambulance
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code282NC0060X
TaxonomyCritical Access Hospital
License NumberH-167
License Number StateWA

VIII. Authorized Official

Name: MR. BRIAN LADY
Title or Position: CEO
Credential:
Phone: 509-775-3333