COLUMBIA BASIN HEALTH ASSOCIATION (NPI# 1528316379) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1528316379 |
| Entity Type | Organization |
| Organization Name | COLUMBIA BASIN HEALTH ASSOCIATION |
| Other Organization Name | EAGLE EYE CARE |
| Practice Address |
1051 S. Columbia Avenue Connell WA 99326 |
| Mailing Address |
140 E Main St Othello WA 99344-1040 |
| Practice Telephone | 5094885256 |
| Practice Fax Number | 5094889939 |
| Mailing Telephone | 5094885256 |
| Mailing Fax Number | 5094889939 |
| Enumeration Date | 2012-08-28 |
| Last Update Date | 2012-08-28 |
| Authorized Official Name | GREG BRANDENBURG (CEO) |
| Authorized Official Telephone | 5094885256 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | DLI CRIME VICTIMS# | 8908941 | 01 |
| WA | RAILROAD MEDICARE | CO3323 | 01 |
| WA | UGS MDC DSHS CROSSOVER | 7107675 | 01 |
| WA | DLI GROUP# | 0035900 | 01 |
| Other Name | Type Code |
|---|---|
| Eagle Eye Care | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629311436 | Columbia Basin Health Association | Durable Medical Equipment & Medical Supplies | 1051 Columbia Avenue, Connell, WA 99326-8702 | 2013-03-29 |
| 1841574241 | Columbia Basin Health Association | Clinic/Center | 1051 S Columbia Ave, Connell, WA 99326-8702 | 2011-10-04 |
| 1417116385 | Columbia Basin Health Association | Clinic/Center | 1051 S Columbia Avenue, Connell, WA 99326 | 2008-06-05 |
| 1013454867 | Columbia Basin Health Association | Clinic/Center | 1515 E Columbia St, Othello, WA 99344-1040 | 2017-01-31 |
| 1427494004 | Columbia Basin Health Association | Clinic/Center | 1515 E Columbia St, Othello, WA 99344-1846 | 2013-05-22 |
| 1710232749 | Columbia Basin Health Association | Clinic/Center | 601 Government Way, Mattawa, WA 99349 | 2012-07-16 |
| 1972721710 | Columbia Basin Health Association | Clinic/Center | 475 N 14th Ave, Othello, WA 99344-1226 | 2007-04-24 |
| 1053539890 | Columbia Basin Health Association | Clinic/Center | 601 Government Way, Mattawa, WA 99349 | 2007-04-24 |
| 1184842254 | Columbia Basin Health Association | Clinic/Center | 601 Government Way, Mattawa, WA 99349 | 2007-04-23 |
| 1992923064 | Columbia Basin Health Association | Optometrist | 1515 E Columbia St, Othello, WA 99344-1846 | 2007-04-23 |
| Street Address |
1051 S. COLUMBIA AVENUE |
| City | CONNELL |
| State | WA |
| Zip Code | 99326 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104392935 | Lois Eileen Smith | Counselor | Coyote Ridge Correction Center, 1301 North Ephrata Ave., Connell, WA 99326 | 2018-10-19 |
| 1538589478 | George Francis Quiggle | Counselor | 1100 W. Grant St., Connell, WA 99326 | 2014-04-18 |
| 1295011617 | Gary Byron Fletcher | Physician Assistant | 111 N Columbia Avenue, Connell, WA 99326 | 2011-10-31 |
| 1871895987 | Jonathan Neau | Physician Assistant | 1301 N Ephrata Ave, Connell, WA 99326 | 2010-11-22 |
| 1417116385 | Columbia Basin Health Association | Clinic/Center | 1051 S Columbia Avenue, Connell, WA 99326 | 2008-06-05 |
| 1952355448 | Catherine Sue Bilyard | Nurse Practitioner | 650 S Columbia Ave, Connell, WA 99326 | 2006-05-20 |
| 1598749590 | Jaeniffer Ang Kaiser | Nurse Practitioner | 661 South Columbia Avenue, Connell, WA 99326 | 2005-12-02 |
| 1124025721 | Dale T Fetroe | Family Medicine | 1301 Ephrata, C/o Coyote Ridge Correction Center, Connell, WA 99326 | 2005-06-28 |
| 1912185588 | Jon Marcus Raymond Mundall | General Practice | 111 North Columbia Ave, Connell, WA 99326 | 2008-02-06 |
| 1538213616 | Our Lady of Lourdes Health Center | Clinic/Center | 650 S Columbia Ave, Connell, WA 99326 | 2007-01-23 |
| Find all providers in zip 99326 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
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| Find all providers with the same taxonomy | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.