| Columbia Basin Health Association | |
|
475 N 14th Ave Othello WA 99344-1226 | |
| (509) 488-5256 | |
| (509) 488-9939 |
| Full Name | Columbia Basin Health Association |
|---|---|
| Speciality | Clinic/center - Federally Qualified Health Center (fqhc) |
| Location | 475 N 14th Ave, Othello, 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 475 N 14th Ave Othello WA 99344-1226 Ph: (509) 488-5256 |
| NPI Number | 1427494004 |
|---|---|
| Provider Enumeration Date | 05/22/2013 |
| Last Update Date | 11/15/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427494004 | NPI | - | NPPES |
| 142749004 | Medicaid | WA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (Washington) | Secondary |
| 261QF0400X | Clinic/center - Federally Qualified Health Center (fqhc) | (* (Not Available)) | Primary |
Othello Dental Arts Clinic, P.s. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1355 E Hemlock St, Othello, WA 99344 Phone: 509-488-5216 Fax: 509-488-9496 | |
Othello Dental Center Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 1515 E Columbia St, Othello, WA 99344 Phone: 509-488-5256 Fax: 509-488-9939 |