Central Washington Health Services Association
Organization Active NPI Rural Health Clinic/Center · Waterville, WA
NPI 1306566070 · NPPES record last updated Sep 1, 2022
Key facts
- NPI
- 1306566070
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Rural Health Clinic/Center 261QR1300X
- Legal business name
- CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION
- Practice address
- 117 S Chelan Ave
Waterville, WA 98858-5903 - Phone
- (509) 745-8461
- NPI assigned
- Sep 1, 2022
- Organization subpart
- Yes
- Parent organization (as reported)
- CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION
Authorized official
- Name
- Andrew Jones, MD
- Title
- Ceo
- Phone
- (509) 662-1511
Owners & managing parties with NPI records 30
Owned or controlled facilities with NPI records 11
Other NPIs with the same Medicare PAC ID 24
Corporate family (same tax ID) 23
Change of ownership 1
Facilities with the same owner 11
Practitioners 708
-
Michael J Abbott, MD
-
Makena Ackerman, ARNP
-
Amith Ahluwalia, MD
-
Jillanna Marie Allen, PA-C, MS, ATC/L
-
Jonathan Walter Allen, M.D.
-
Kathleen S Allen, PA-C
-
Richard Derek Allen, PA-C
-
Stephen Killefer Allison, M.D.
-
Jose L Alvarez, OD
-
Caleb R Ambrose, PA-C
-
Nicole Marie Anderson, ARNP
-
Erin Christine Andrade, M.D.
-
Joseph Anzalone, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in WA
Rural health clinic certification: CCN 503937
- Legal name
- CENTRAL WASHINGTON HEALTH SERVICES ASSOCIATION
- Doing business as
- CONFLUENCE HEALTH WATERVILLE CLINIC
- Certification status
- Active
- Provider type (POS)
- Rural health clinic
- Participating since
- Jul 1, 2023
- Last certification
- Jul 16, 2014
- Ownership / control type
- 2B
- Organization structure
- Corporation · Non-profit
- Incorporated
- Jan 1, 1966 in WA
- Enrollment address
- 117 S Chelan Ave
Waterville, WA 98858-5903
All disclosed owners & managing parties 20
| Name | Role | Since | Share |
|---|---|---|---|
| Jeffrey Neher |
Corporate Director |
Jul 1, 2024 | |
| Lauren Weber |
Corporate Director | Dec 1, 2023 | |
| Jennifer E Jorgensen |
Corporate Director |
Jul 1, 2023 | |
| David Balcom |
Corporate Director |
Jul 1, 2023 | |
| Christina M Cox |
Corporate Director | Jul 1, 2023 | |
| W-2 Managing Employee | Jul 1, 2023 | ||
| Vicky Scharlau |
Corporate Director |
Jul 1, 2023 | |
| Andrew D Jones |
Corporate Officer |
Jul 1, 2023 | |
| Corporate Director | Jul 1, 2023 | ||
| Eric J Caldwell |
Corporate Officer |
Dec 16, 2024 | |
| Corinne Bautista |
Corporate Director |
Jul 1, 2023 | |
| Central Washington Health Services Association |
Operational/Managerial Control | Jul 1, 2023 | |
| Daniel J Kerr |
Corporate Director | Aug 1, 2023 | |
| Juan Diaz |
Corporate Director |
May 1, 2026 | |
| Sri Krishnan |
Corporate Director |
May 1, 2026 | |
| Brianna Keith |
Corporate Director | Mar 1, 2024 | |
| W-2 Managing Employee | Mar 1, 2024 | ||
| Luther Thompson |
Corporate Director |
Apr 1, 2024 | |
| Ensi Voshtina |
Corporate Director |
Feb 1, 2025 | |
| Dianne Probach |
Corporate Director |
May 1, 2026 | |
| Abraham James Sorom |
Corporate Director |
Jul 1, 2023 | |
| Garn Christensen |
Corporate Director |
Jul 1, 2023 | |
| Vanessa Gutierrez |
Corporate Director |
Jul 1, 2023 |
All facility ownership & control disclosures 11
| Facility | Type | Role | Since |
|---|---|---|---|
| Central Washington Health Services |
Home health agency | Operational/Managerial Control | Jul 21, 2013 |
| Confluence Health Tonasket Clinic |
Rural health clinic | Operational/Managerial Control | Jul 13, 2023 |
| Confluence Health Oroville Clinic |
Rural health clinic | Operational/Managerial Control | Jul 13, 2013 |
| Confluence Health Moses Lake Clinic |
Rural health clinic | Operational/Managerial Control | Jul 13, 2023 |
| Confluence Health Wenatchee Clinic |
Rural health clinic | Operational/Managerial Control | Jul 1, 2013 |
| Confluence Health Ephrata Clinic |
Rural health clinic | Operational/Managerial Control | Jul 1, 2023 |
| Confluence Health Brewster Clinic |
Rural health clinic | Operational/Managerial Control | Jul 1, 2023 |
| Confluence Health Cashmere Clinic |
Rural health clinic | Operational/Managerial Control | Jul 13, 2013 |
| Confluence Health Omak Clinic |
Rural health clinic | Operational/Managerial Control | Jul 13, 2013 |
| Confluence Health E Wenatchee Clinic |
Rural health clinic | Operational/Managerial Control | Jul 1, 2023 |
| Confluence Health Royal City Clinic |
Rural health clinic | Operational/Managerial Control | Jul 13, 2013 |
Change-of-ownership history
| Date | Event | Counterparty |
|---|---|---|
| Jul 1, 2023 | Change of Ownership |
Confluence Health Waterville |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20230712001730 | WA | Part a Provider - Rural Health Clinic | 4880504596 | Practice locations: Waterville, WA |
National Provider Directory
- Tax ID family
- Central Wa Health SVCS
- Part of
- Central Wa Health SVCS
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Rural Health Clinic/Center | 261QR1300X | Yes |
Addresses
Primary practice location
117 S Chelan Ave
Waterville, WA 98858-5903
Mailing address
PO Box 361
Wenatchee, WA 98807-0361
Phone (509) 662-1511
Other names
- CONFLUENCE HEALTH WATERVILLE CLINIC
Other providers in Waterville, WA
- Central Washington Health Services Assocation
- Douglas County Hospital Dist #2
- Douglas County Hospital District 2
- Eastmont Pharmacy Inc
- Steven J Mongeon
- Pamela Dawn Prpich
All providers in Waterville, WA · Rural Health Clinic/Center in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Sep 1, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- CMS facility enrollments, All Owners and change-of-ownership files: CCNs, owners and managing parties.
- Provider of Services files (CMS): certification status, beds and related CCNs.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.