NPIMap

Organization Active NPI

Columbia Valley Community Health

Doing business as 980 East Behavioral

  • Federally Qualified Health Center (FQHC)
  • East Wenatchee, WA
National Provider Identifier
1174417919
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COLUMBIA VALLEY COMMUNITY HEALTH
Doing business as
980 East Behavioral
Practice address
980 Eastmont Ave
East Wenatchee, WA 98802-6602
Phone
(509) 662-6000
NPI assigned
Jun 5, 2025
Last updated
Jun 5, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
COLUMBIA VALLEY COMMUNITY HEALTHAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Authorized official

Name
Manuel I Navarro
Title
Ceo
Phone
(509) 666-2600

Specialties & licenses 5

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Adult Mental Health Clinic/Center 261QM0850X
Adolescent and Children Mental Health Clinic/Center 261QM0855X

Addresses

Primary practice location

980 Eastmont Ave
East Wenatchee, WA 98802-6602

Mailing address

600 Orondo Ave Ste 1
Wenatchee, WA 98801-2800
Phone (509) 662-6000

Other names 1

  • 980 East Behavioral Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250306002517 WA Part A Provider - Federally Qualified Health Center (FQHC) 7113813874 2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: East Wenatchee, WA

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1174417919. Details of each certification follow.

Federally qualified health center certification: CCN 501066

Legal name
COLUMBIA VALLEY COMMUNITY HEALTH
Doing business as
980 PSYCHIATRIC MEDICAL
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
May 1, 2025
Last certification
May 1, 2025
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
980 Eastmont Ave
East Wenatchee, WA 98802-6602

Other NPIs on the same Medicare enrollment 2

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

National Provider Directory

National Provider Directory
Tax ID family
Columbia Valley Community Health East Wenatchee Pharmacy8 organizations share this tax ID, including this one
Part of
Columbia Valley Community Health East Wenatchee Pharmacy

Other organizations with this tax ID 7

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

Locations

900 Eastmont Ave
East Wenatchee, WA 98802
Phone (509) 884-9000

940 Eastmont Ave
East Wenatchee, WA 98802
Phone (509) 884-9000

1224 Methow St
Wenatchee, WA 98801

145 S Worthen St
Wenatchee, WA 98801
Phone (509) 662-6712

1510 9th St
Wenatchee, WA 98801
Phone (509) 663-7947

230 Grant Rd
Ste A25
Wenatchee, WA 98802
Phone (509) 884-9040

701 N Miller St
Wenatchee, WA 98801
Phone (509) 662-7195

819 N Miller St
Ste 1B
Wenatchee, WA 98801
Phone (509) 664-4592

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Susan E Caverly Individual W-2 Managing EmployeeExecutive Director of BH Mar 21, 2023
Kristina Stepper Individual Corporate DirectorBoard Member May 15, 2013
Summer Kelley Individual Corporate OfficerChief Financial Officer Jul 23, 2024
W-2 Managing EmployeeChief Financial Officer Jun 5, 2019
Kevin Brown Individual Corporate DirectorBoard Member Aug 24, 2022
Manuel Navarro Individual Corporate OfficerChief Executive Officer Jul 1, 2019
W-2 Managing EmployeeChief Executive Officer Jul 2, 2019
Dusti Mahoney Individual Corporate DirectorBoard Member Jan 21, 2020
Blake Edwards Individual W-2 Managing EmployeeChief Quality & Compliance Officer Jul 31, 2018
Richard Clark Hansen Individual Corporate DirectorBoard Member Aug 24, 2022
Robert H Scott Individual Corporate DirectorBoard Member Mar 1, 1998
Danielle Noell Individual W-2 Managing EmployeeChief Operations Officer Oct 24, 2011
Jeffery Hinckley Individual W-2 Managing EmployeeExecutive Director of Dental Nov 1, 2018
Felipe Gutierrez Individual W-2 Managing EmployeeChief Medical Officer Nov 16, 2021
Yvonne Mayorga Individual Corporate DirectorBoard Member May 29, 2024
Columbia Valley Community Health Organization, Wenatchee, WA Non-profit Operational/Managerial Control Jun 1, 1975 100%
Loly Larson Individual Corporate DirectorBoard Member Apr 1, 1990
Cheryl Cooper Individual Corporate DirectorBoard Member Sep 24, 2024
Michael Machado Individual Corporate DirectorBoard Member Sep 12, 2017

Owners & managing parties with NPI records 9

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 109

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 109

NPI Registry JSON

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1174417919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "600 ORONDO AVE STE 1",
            "city": "WENATCHEE",
            "state": "WA",
            "postal_code": "988012800",
            "telephone_number": "509-662-6000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 EASTMONT AVE",
            "city": "EAST WENATCHEE",
            "state": "WA",
            "postal_code": "988026602",
            "telephone_number": "509-662-6000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COLUMBIA VALLEY COMMUNITY HEALTH",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "COLUMBIA VALLEY COMMUNITY HEALTH",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "NAVARRO",
        "authorized_official_first_name": "MANUEL",
        "authorized_official_middle_name": "I",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-666-2600"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM0855X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adolescent and Children Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "980 East Behavioral",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Wenatchee, WA

Sources for this page

Verify at the official NPI Registry.