GRANT COUNTY PUBLIC HOSPITAL DISTRICT 5 (NPI# 1699720797) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1699720797 |
| Entity Type | Organization |
| Organization Name | GRANT COUNTY PUBLIC HOSPITAL DISTRICT 5 |
| Other Organization Name | MATTAWA COMMUNITY MEDICAL CLINIC |
| Practice Address |
210 Government Road Mattawa WA 99349-0960 |
| Mailing Address |
Po Box 1581 Mattawa WA 99349-0960 |
| Practice Telephone | 5099324499 |
| Practice Fax Number | 5099325363 |
| Mailing Telephone | 5099324499 |
| Mailing Fax Number | 5099325363 |
| Enumeration Date | 2006-05-24 |
| Last Update Date | 2019-12-16 |
| Authorized Official Name | DANA S FOX (CEO/EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 5099324499 |
| Authorized Official Credential | CMA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | Allopathic & Osteopathic Physicians | ||
| N | 363L00000X | Nurse Practitioner | Physician Assistants & Advanced Practice Nursing Providers | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
WA | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| WA | MEDICARE PTAN | 501944 | 01 |
| WA | 7044167 | 05 | |
| WA | DSHS FEE FOR SERVICE | 7035611 | 01 |
| WA | DSHS MSS | 7406572 | 01 |
| WA | LABOR & INDUSTRIES | 67850 | 01 |
| WA | DSHS TAKE CHARGE | 7900657 | 01 |
| Other Name | Type Code |
|---|---|
| Mattawa Community Medical Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1609410075 | Grant County Public Hospital District 5 | Clinic/Center | 101 William Ave, Mattawa, WA 99349-0104 | 2019-10-29 |
| 1396384871 | Grant County Public Hospital District 5 | Pharmacy | 210 Government Road, Mattawa, WA 99349 | 2019-12-31 |
| 1003391848 | Grant County Public Hospital District 5 | Pharmacy | 210 Government Road, Mattawa, WA 99349 | 2018-09-27 |
| Street Address |
210 GOVERNMENT ROAD |
| City | MATTAWA |
| State | WA |
| Zip Code | 99349-0960 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396384871 | Grant County Public Hospital District 5 | Pharmacy | 210 Government Road, Mattawa, WA 99349 | 2019-12-31 |
| 1174177471 | Bryan Duane Larson | Nurse Practitioner | 210 Government Road, Mattawa, WA 99349-0906 | 2019-07-25 |
| 1003391848 | Grant County Public Hospital District 5 | Pharmacy | 210 Government Road, Mattawa, WA 99349 | 2018-09-27 |
| 1124298336 | Cheryl Marie Mielbrecht | Physician Assistant | 210 Government Road, Mattawa, WA 99349-0960 | 2008-03-04 |
| 1497924088 | Cynthia A Johnson | Dietitian, Registered | 210 Government Road, Mattawa, WA 99349-0960 | 2008-02-27 |
| 1427003540 | Daniel E Sloane | Family Medicine | 210 Government Road, Mattawa, WA 99349 | 2006-05-24 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396997086 | Elaine Marie Brewer | Massage Therapist | 210 Government Rd., Mattawa, WA 99349 | 2008-10-14 |
| 1629148440 | Arturo Rojas | Physician Assistant | 601 Government Way, Mattawa, WA 99349 | 2006-11-09 |
| 1740363498 | Wahluke School District | Local Education Agency (LEA) | 411 E Saddle Mountain Drive, Mattawa, WA 99349 | 2006-10-23 |
| 1700314895 | Geraldine Cabero | Physician Assistant | 601 Government Way, Mattawa, WA 99349 | 2017-06-01 |
| 1710232749 | Columbia Basin Health Association | Clinic/Center | 601 Government Way, Mattawa, WA 99349 | 2012-07-16 |
| 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 |
| 1033259064 | Columbia Basin Health Association | Pharmacist | 601 Government Way, Mattawa, WA 99349 | 2007-02-07 |
| 1609410075 | Grant County Public Hospital District 5 | Clinic/Center | 101 William Ave, Mattawa, WA 99349-0104 | 2019-10-29 |
| 1134337785 | Jennifer Beaty | Registered Nurse | 210 Government Rd, Mattawa, WA 99349-0960 | 2007-05-18 |
| Find all providers in zip 99349 | ||||
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710232749 | Columbia Basin Health Association | Clinic/Center | 601 Government Way, Mattawa, WA 99349 | 2012-07-16 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447869342 | Unity Care Northwest | Clinic/Center | 6046 Portal Way Ste 202, Ferndale, WA 98248-7829 | 2020-07-27 |
| 1881219426 | Healthpoint | Clinic/Center | 2902 Ne 12th St Ste 102, Renton, WA 98056-3126 | 2020-06-09 |
| 1235778812 | Seattle Indian Health Board | Clinic/Center | 410 2nd Avenue Ext S, Seattle, WA 98104-2876 | 2019-12-31 |
| 1376185694 | Neighborcare Health | Clinic/Center | 2709 3rd Ave, Seattle, WA 98121-1217 | 2019-10-09 |
| 1295383958 | King County Finance | Clinic/Center | 908 Jefferson St Fl 11, Seattle, WA 98104-2433 | 2019-08-27 |
| 1063069839 | Sea-mar Community Health Center | Clinic/Center | 6004 Capitol Boulevard Southwest, Tumwater, WA 98501-8520 | 2019-08-26 |
| 1194379354 | Yakima Neighborhood Health Services | Clinic/Center | 201 S 6th St, Yakima, WA 98901-2928 | 2019-07-26 |
| 1881254449 | Neighborcare Health | Clinic/Center | 7101 62nd Ave Ne Ste 4, Seattle, WA 98115-7168 | 2019-06-17 |
| 1578028866 | Neighborcare Health | Clinic/Center | 2119 3rd Ave, Seattle, WA 98121-2333 | 2019-01-31 |
| 1144703885 | Healthpoint | Clinic/Center | 219 State Ave N, Ste 100, Kent, WA 98030 | 2018-09-10 |
| 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.