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Lewis County Hospital District No 1

Organization Active NPI Rural Health Clinic/Center · Mossyrock, WA

NPI 1205110830 · NPPES record last updated Dec 4, 2025

Key facts

NPI
1205110830
Entity type
Organization (NPI type 2)
Primary specialty
Rural Health Clinic/Center 261QR1300X
License
H173 (WA)
Legal business name
LEWIS COUNTY HOSPITAL DISTRICT NO 1
Practice address
745 Williams Street
Mossyrock, WA 98564
Phone
(360) 983-8990
Fax
(360) 983-8995
NPI assigned
Sep 30, 2011
Organization subpart
No

Authorized official

Name
Janice Cramer
Title
Authorized Official
Phone
(360) 496-5112

Owned or controlled facilities with NPI records 4

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Other NPIs with the same Medicare PAC ID 6

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Corporate family (same tax ID) 8

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

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

Practitioners 27

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

View all 27

Medicare participation

Medicare fee-for-service enrollment
Enrolled in WA

Rural health clinic certification: CCN 508557

Legal name
LEWIS COUNTY HOSPITAL DISTRICT NO 1
Doing business as
ARBOR HEALTH MOSSYROCK CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 10, 2007
Last certification
Jan 29, 2014
Ownership / control type
Non-profit – church related
Organization structure
Government · Non-profit
Incorporated
Dec 2, 1976 in WA
Enrollment address
745 Williams St
Mossyrock, WA 98564-9004
Related CCNs
501319

All disclosed owners & managing parties 5

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

NameRoleSinceShare
Craig Coppock
Individual 		Corporate Director
Board Member		 Jan 1, 2022
Janice Cramer
Individual 		Corporate Director Apr 11, 2025
Operational/Managerial Control Aug 1, 2025
Tom Herrin
Individual 		Corporate Director
Board Member		 Jan 1, 2020
Eric Neal
Individual 		Corporate Officer
Ceo		 Aug 26, 2025
W-2 Managing Employee
Ad;		 Aug 25, 2025
Wes McMahan
Individual 		Corporate Director
Board Member		 Jan 1, 2020

All facility ownership & control disclosures 4

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Arbor Health Morton Hospital
Morton, WA · CCN 501319		 Hospital Operational/Managerial Control Dec 2, 1976
Arbor Health Morton Hospital
Morton, WA · CCN 50Z319		 Hospital Operational/Managerial Control Dec 2, 1976
Arbor Health Randle Clinic
Randle, WA · CCN 508511		 Rural health clinic Other Dec 2, 1976
Arbor Health Packwood Clinic
Packwood, WA · CCN 508597		 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control (100%)		 Apr 1, 2023
Apr 1, 2023

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20120126000601 WA Part a Provider - Rural Health Clinic 6002727385 Practice locations: Mossyrock, WA

National Provider Directory

Tax ID family
Lewis County Hosp Dist No 1 (9 organizations share this tax ID)

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Rural Health Clinic/Center 261QR1300X H173 WA Yes

Addresses

Primary practice location

745 Williams Street
Mossyrock, WA 98564

Mailing address

PO Box 1138
Morton, WA 98356-0019
Phone (360) 496-3702

Other names

  • Arbor Health Mossyrock Clinic Doing business as

Other providers in Mossyrock, WA

All providers in Mossyrock, WA · Rural Health Clinic/Center in Washington

Sources for this page

Verify at the official NPI Registry.