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General NPI Number Information
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NPI Number | 1386473551
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Entity Type | Organization
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Legal Business Name | GREENBRIDGE HEALTH CLINIC
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Dates
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Enumeration Date | 07/29/2024
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Last Update Date | 01/18/2025
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Provider Practice Location Address
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Address Line | 4256 W 24TH AVE STE 101
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City | KENNEWICK
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State | WA
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Zip | 99338-7171
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Country | US
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Telephone | 509-802-3664
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Fax |
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Provider Business Mailing Address
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Address Line | 2560 CASA BELLA AVE
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City | RICHLAND
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State | WA
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Zip | 99352-5527
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Country | US
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Telephone | 708-916-5798
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Fax |
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Authorized Official
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Title or Position | PMHNP
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Name | MIRIAM OKOCHI
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Credential | ARNP
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Telephone | 708-916-5798
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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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 | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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