Tri-State Memorial Hospital

Organization Active NPI Home Health Agency · Clarkston, WA

NPI 1124135215 · NPPES record last updated May 16, 2012

Key facts

NPI
1124135215
Entity type
Organization (NPI type 2)
Primary specialty
Home Health Agency 251E00000X
License
15457 (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
Organization subpart
No

Authorized official

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

Practitioners 24

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Locations

1119 Highland Ave
Ste 4
Clarkston, WA 99403
Phone (509) 254-0080

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

Specialties & licenses

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

Addresses

Primary practice location

1100 Highland Avenue
Clarkston, WA 99403

Mailing address

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

Other identifiers

IdentifierTypeStateIssuer
9044330MedicaidWA

Other providers in Clarkston, WA

All providers in Clarkston, WA · Home Health Agency in Washington

Sources for this page

Verify at the official NPI Registry.