NPIMap

Organization Active NPI

Okanogan Douglas District Hospital #1

  • Critical Access Hospital
  • Brewster, WA
National Provider Identifier
1043363591
Registry record updated Jun 26, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Critical Access HospitalTaxonomy code 282NC0060X
License
H23 Issued in WA
Legal business name
OKANOGAN DOUGLAS DISTRICT HOSPITAL #1
Practice address
507 Hospital Way
Brewster, WA 98812-0507
Phone
(509) 689-2517
Fax
(509) 689-2086
NPI assigned
Jan 19, 2007
Organization subpart
Yes
Parent organization
OKANOGAN DOUGLAS DISTRICT HOSPITAL #1As reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 26, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Mrs. Jennifer Munson
Title
Cfo
Phone
(509) 689-2517

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Critical Access Hospital 282NC0060X H23 WA Primary

Addresses

Primary practice location

507 Hospital Way
Brewster, WA 98812-0507

Mailing address

PO Box 577
Brewster, WA 98812-0577
Phone (509) 689-2517

Other identifiers 1

IdentifierTypeStateIssuer
091OtherWAPREMERA BLUE CROSS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080107000645 WA Part A Provider - Critical Access Hospital 7810882792 Receives reassigned benefits from 165 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Brewster, WA

Hospital certification: CCN 501324

Legal name
OKANOGAN DOUGLAS COUNTY HOSPITAL DIST 1
Doing business as
THREE RIVERS HOSPITAL
Certification status
Active
Provider type (POS)
Hospital – Critical access hospital
Participating since
Dec 1, 2002
Last certification
Feb 6, 2025
Beds
43 (25 certified)
Ownership / control type
Hospital district or authority
Organization structure
CorporationNon-profit
Incorporated
Jan 12, 1949 in WA
Enrollment address
507 Hospital Way
Brewster, WA 98812-0019
Main/Primary Hospital Location

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Care Compare: Hospital

Medicare Care Compare
Listed as
Three Rivers HospitalCCN 501324
Type
Critical Access Hospitals
Ownership
Government - Hospital District or Authority
Medicare certification status
ActiveFrom the Provider of Services file
Emergency services
Yes

National Provider Directory

National Provider Directory
Tax ID family
Okanogan Douglas District Hospital16 organizations share this tax ID, including this one
Part of
Okanogan Douglas District Hospital

Other organizations with this tax ID 15

Organizations that report the same tax identification number in the National Provider Directory.

View all 15

Ownership & related parties

All disclosed owners & managing parties 9

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
James S Graham Individual Corporate OfficerChief Executive Officer May 12, 2014
David Garcia Individual Corporate DirectorBoard Member Apr 29, 2020
Tracy D Shrable Individual Corporate DirectorBoard Member Nov 22, 2010
Wanda S Celeone Individual W-2 Managing EmployeeOffice Manager Oct 29, 2007
Anita Fisk Individual Corporate DirectorDirector of Human Resources Oct 24, 2011
Christina Smith Individual Corporate OfficerChief Nursing Officer Jan 6, 2022
Mike Pruett Individual Corporate DirectorBoard Chair Jan 28, 2013
Cherri Thomas Individual Corporate DirectorVice Chairman Jan 1, 2014
Leslie G McNamara Individual Corporate DirectorSecretary Aug 29, 2017

Practitioners & affiliated clinicians

Affiliated clinicians 45

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 45

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169164800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1214438400000",
    "number": "1043363591",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 577",
            "city": "BREWSTER",
            "state": "WA",
            "postal_code": "988120577",
            "telephone_number": "509-689-2517",
            "fax_number": "509-689-2086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "507 HOSPITAL WAY",
            "city": "BREWSTER",
            "state": "WA",
            "postal_code": "988120507",
            "telephone_number": "509-689-2517",
            "fax_number": "509-689-2086"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "OKANOGAN DOUGLAS DISTRICT HOSPITAL #1",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "OKANOGAN DOUGLAS DISTRICT HOSPITAL #1",
        "enumeration_date": "2007-01-19",
        "last_updated": "2008-06-26",
        "status": "A",
        "authorized_official_last_name": "MUNSON",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "509-689-2517",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "282NC0060X",
            "taxonomy_group": "",
            "desc": "General Acute Care Hospital, Critical Access",
            "state": "WA",
            "license": "H23",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PREMERA BLUE CROSS",
            "identifier": "091",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Brewster, WA

Sources for this page

Verify at the official NPI Registry.