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General NPI Number Information
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NPI Number | 1740289560
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Entity Type | Organization
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Legal Business Name | SUNNYSIDE COMMUNITY HOSPITAL ASSOCIATION
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Dates
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Enumeration Date | 07/14/2005
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Last Update Date | 11/13/2017
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Provider Practice Location Address
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Address Line | 222 E 2ND ST
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City | GRANDVIEW
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State | WA
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Zip | 98930-1342
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Country | US
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Telephone | 509-203-6501
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Fax | 509-203-6504
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Provider Business Mailing Address
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Address Line | PO BOX 510
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City | SUNNYSIDE
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State | WA
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Zip | 98944-0510
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Country | US
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Telephone | 509-203-6501
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Fax | 509-203-6504
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Authorized Official
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Title or Position | BUSINESS OFFICE MANAGER
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Name | KIM LAWSON
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Credential |
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Telephone | 509-837-1617
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QA0505X
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Taxonomy Name | Adult Medicine Physician
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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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 | 367A00000X
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Taxonomy Name | Advanced Practice Midwife
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology 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 | 261QR1300X
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Taxonomy Name | Rural Health Clinic/Center
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License Number |
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License Number State |
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