Healthcare Provider Details

I. General information

NPI: 1588349856
Provider Name (Legal Business Name): CENTRAL WASHINGTON HEALTH SERVICES ASSOCATION
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/15/2023
Last Update Date: 06/15/2023
Certification Date: 06/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

102 CAMELIA ST NW
ROYAL CITY WA
99357
US

IV. Provider business mailing address

1201 S MILLER ST
WENATCHEE WA
98801-3201
US

V. Phone/Fax

Practice location:
  • Phone: 509-764-6447
  • Fax: 509-764-6435
Mailing address:
  • Phone: 509-433-3030
  • Fax: 509-433-3008

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code3336C0002X
TaxonomyClinic Pharmacy
License Number
License Number State

VIII. Authorized Official

Name: MS. CYNTHIA S. POTTS
Title or Position: PHARMACY MANAGER
Credential: RPH
Phone: 509-433-3030