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General NPI Number Information
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NPI Number | 1780495978
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Entity Type | Organization
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Legal Business Name | PROSSER PUBLIC HOSPITAL DISTRICT OF BENTON COUNTY
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Dates
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Enumeration Date | 01/16/2025
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Last Update Date | 01/16/2025
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Provider Practice Location Address
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Address Line | 820 MEMORIAL ST STE 3
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City | PROSSER
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State | WA
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Zip | 99350-2504
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Country | US
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Telephone | 509-786-2222
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 84112
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City | SEATTLE
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State | WA
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Zip | 98124-5412
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Country | US
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Telephone | 509-786-2222
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | CRAIG MARKS
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Credential |
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Telephone | 509-786-2222
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation 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 | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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