NPIMap

Organization Active NPI

Tri-State Memorial Hospital

  • Home Health Agency
  • Clarkston, WA
National Provider Identifier
1124135215
Registry record updated May 16, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
15457 Issued in WA
Legal business name
TRI-STATE MEMORIAL HOSPITAL
Practice address
1100 Highland Avenue
Clarkston, WA 99403
Phone
(509) 758-2568
Fax
(509) 758-3413
NPI assigned
Aug 24, 2006
Last updated
May 16, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 16, 2012

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

Authorized official

Name
Mr. Alex C Town
Title
Cfo
Phone
(509) 758-4667

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X 15457 WA Primary

Addresses

Primary practice location

1100 Highland Avenue
Clarkston, WA 99403

Mailing address

PO Box 187
Clarkston, WA 99403-0187
Phone (509) 758-5511

National Provider Directory

National Provider Directory

Locations

1119 Highland Ave
Ste 10
Clarkston, WA 99403
Phone (509) 758-1450

1119 Highland Ave
Ste 2
Clarkston, WA 99403
Phone (509) 758-9404

Practitioners & affiliated clinicians

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1337126400000",
    "number": "1124135215",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 187",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "994030187",
            "telephone_number": "509-758-5511",
            "fax_number": "509-751-9406"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1100 HIGHLAND AVENUE",
            "city": "CLARKSTON",
            "state": "WA",
            "postal_code": "99403",
            "telephone_number": "509-758-2568",
            "fax_number": "509-758-3413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRI-STATE MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-24",
        "last_updated": "2012-05-16",
        "status": "A",
        "authorized_official_last_name": "TOWN",
        "authorized_official_first_name": "ALEX",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "509-758-4667",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "WA",
            "license": "15457",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarkston, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.