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General NPI Number Information
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NPI Number | 1154198653
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Entity Type | Organization
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Legal Business Name | BASALT FAMILY WELLNESS, LLC
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Dates
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Enumeration Date | 12/06/2023
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Last Update Date | 09/11/2025
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Provider Practice Location Address
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Address Line | 1005 S CANYON RD
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City | ELLENSBURG
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State | WA
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Zip | 98926-4108
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Country | US
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Telephone | 509-426-3750
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Fax | 509-426-3760
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Provider Business Mailing Address
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Address Line | 1005 S CANYON RD
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City | ELLENSBURG
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State | WA
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Zip | 98926-4108
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Country | US
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Telephone | 509-426-3750
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Fax | 509-426-3760
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Authorized Official
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Title or Position | OWNER
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Name | MACY A SCHORNO
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Credential | ARNP
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Telephone | 509-306-1898
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QF0050X
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Taxonomy Name | Non-Surgical Family Planning Clinic/Center
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 261QH0100X
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Taxonomy Name | Health Service Clinic/Center
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #5
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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