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General NPI Number Information
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NPI Number | 1740133560
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Entity Type | Organization
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Legal Business Name | KOINONIA CHRISTIAN CAMP AND RETREAT CENTER
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Dates
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Enumeration Date | 02/19/2026
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 850 CAMP KOINONIA LANE
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City | CLE ELUM
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State | WA
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Zip | 98922-8820
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Country | US
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Telephone | 509-304-9541
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Fax |
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Provider Business Mailing Address
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Address Line | 850 CAMP KOINONIA LANE
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City | CLE ELUM
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State | WA
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Zip | 98922-8820
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Country | US
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Telephone | 509-304-9541
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Fax |
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Authorized Official
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Title or Position | DIRECTOR
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Name | SCOTT WEBB
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Credential |
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Telephone | 253-225-1691
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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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 | 385HR2050X
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Taxonomy Name | Respite Care Camp
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License Number |
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License Number State |
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