Healthcare Provider Details
I. General information
NPI: 1811555931
Provider Name (Legal Business Name): OKANOGAN COUNTY PUBLIC HOSPITAL DIST NO 4
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 06/04/2019
Last Update Date: 04/16/2025
Certification Date: 04/16/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
118 S WHITCOMB AVE
TONASKET WA
98855-9287
US
IV. Provider business mailing address
203 S WESTERN AVE
TONASKET WA
98855-8803
US
V. Phone/Fax
- Phone: 506-486-3191
- Fax: 509-223-1743
- Phone: 509-486-2151
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 261QR1300X |
| Taxonomy | Rural Health Clinic/Center |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: MR.
JOHN
ALEXANDER
MCREYNOLDS
Title or Position: COO
Credential:
Phone: 509-486-3128