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General NPI Number Information
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NPI Number | 1366446767
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Entity Type | Organization
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Legal Business Name | PUBLIC HOSPITAL DISTRICT #1-A OF WHITMAN COUNTY
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Dates
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Enumeration Date | 06/13/2005
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Last Update Date | 10/22/2025
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Provider Practice Location Address
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Address Line | 835 SE BISHOP BLVD
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City | PULLMAN
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State | WA
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Zip | 99163-5512
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Country | US
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Telephone | 509-332-2514
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Fax | 509-332-0731
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Provider Business Mailing Address
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Address Line | 835 SE BISHOP BLVD
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City | PULLMAN
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State | WA
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Zip | 99163-5512
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Country | US
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Telephone | 509-332-2514
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Fax | 509-336-7642
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Authorized Official
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Title or Position | CHIEF EXECUTIVE OFFICER
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Name | MATT FORGE
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Credential | CEO
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Telephone | 509-336-7300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QU0200X
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Taxonomy Name | Urgent Care 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 | 247100000X
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Taxonomy Name | Radiologic Technologist
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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 | 261QC0050X
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Taxonomy Name | Critical Access Hospital 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 | 207PE0004X
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Taxonomy Name | Emergency Medical Services (Emergency Medicine) Physician
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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 | 291U00000X
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Taxonomy Name | Clinical Medical Laboratory
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License Number |
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License Number State |
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Taxonomy #6
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Taxonomy Code | 282NC0060X
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Taxonomy Name | Critical Access Hospital
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License Number | H-172
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License Number State | WA
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