| Columbia Basin Health Association | |
|
601 Government Way Mattawa WA 99349 | |
| (509) 932-3535 | |
| (509) 488-9939 |
| Full Name | Columbia Basin Health Association |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 601 Government Way, Mattawa, Washington |
| Authorized Official Name and Position | Nieves Gomez (CEO) |
| Authorized Official Contact | 5094885256 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Columbia Basin Health Association 1515 E Columbia St Othello WA 99344-1846 Ph: (509) 488-5256 | Columbia Basin Health Association 601 Government Way Mattawa WA 99349 Ph: (509) 932-3535 |
| NPI Number | 1184842254 |
|---|---|
| Provider Enumeration Date | 04/23/2007 |
| Last Update Date | 05/06/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184842254 | NPI | - | NPPES |
| 5031778 | Medicaid | WA | |
| 8923240 | Other | WA | CRIME VICTIMS # |
| 0134585 | Other | WA | DEPT L&I # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Washington) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (Washington) | Primary |