Public Hospital District #1-a of Whitman County
Organization Active NPI Critical Access Hospital · Pullman, WA
NPI 1366446767 · NPPES record last updated Oct 22, 2025
Key facts
- NPI
- 1366446767
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Critical Access Hospital 282NC0060X
- License
- H-172 (WA)
- Legal business name
- PUBLIC HOSPITAL DISTRICT #1-A OF WHITMAN COUNTY
- Practice address
- 835 SE Bishop Blvd
Pullman, WA 99163-5512 - Phone
- (509) 332-2514
- Fax
- (509) 332-0731
- NPI assigned
- Jun 13, 2005
- Organization subpart
- No
Authorized official
- Name
- Matt Forge, CEO
- Title
- Chief Executive Officer
- Phone
- (509) 336-7300
Other NPIs on the same Medicare enrollment 1
Other NPIs with the same Medicare PAC ID 1
Related certifications (CCN) 1
Practitioners 177
-
Bryan Robert Anderson, D.O.
-
Jessie M Armstrong, SLP
-
Lisa Arrett, ARNP
-
Deborah Blazzard, PMHNP
-
Kaz B Brodsky, MD
-
Morgan Elizabeth Burke, FNP-C
-
Bradly John Capawana, DPM
-
Stacey K Clark, M.D.
-
Justin Cochrane, D.O
-
Jennifer L Davis, PA-C
-
Clara E Garcia, MD
-
Christyonne P Gould, OTR/L
-
Nancy Gregory, A.R.N.P.
-
Harshwant Grover, M.D.
-
Kent B Gustin, CRNA
-
Stephen P Hall, M.D.
-
Brenna R Harris, D.O.
-
Mark A. Hoover, M.D.
-
Richard L Howell, ARNP
-
James Lee Hug, DNP, CRNA
Affiliated clinicians 204
-
C. Mark Alder, MD
-
Bryan Robert Anderson, D.O.
-
Lisa Arrett, ARNP
-
Timothy Charles Ball, M.D. PH.D.
-
Kevin T Bauerle, MD
-
John William Bell, M.D.
-
Tristan T Berry, M.D.
-
Deborah Blazzard, PMHNP
-
Christina Marie Borselli, ARNP, FNP-BC, RN
-
Beth Ann Bremer, ARNP
-
Kaz B Brodsky, MD
-
Cory Allen Brown, D.P.M.
-
Morgan Elizabeth Burke, FNP-C
-
Bradly John Capawana, DPM
-
Maria C. Cassel, PA-C
-
Stacey K Clark, M.D.
-
Justin Cochrane, D.O
Medicare Care Compare: Hospital
- Listed as
- Pullman Regional Hospital
- Overall star rating
- ★★☆☆☆ 2 of 5
- Type
- Critical Access Hospitals
- Ownership
- Government - Hospital District or Authority
- Medicare certification status
- Active
- Emergency services
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (3 enrollments) in WA, ID
Hospital certification: CCN 501331
- Legal name
- PUBLIC HOSPITAL DISTRICT #1-A OF WHITMAN COUNTY
- Doing business as
- PULLMAN REGIONAL HOSPITAL
- Certification status
- Active
- Provider type (POS)
- Hospital – Critical access hospital
- Participating since
- Jun 1, 2004
- Last certification
- May 17, 2012
- Beds
- 25
- Ownership / control type
- Hospital district or authority
- Organization structure
- Other · Non-profit
- Incorporated
- in WA
- Enrollment address
- 835 SE Bishop Blvd
Pullman, WA 99163-5512
All disclosed owners & managing parties 3
| Name | Role | Since | Share |
|---|---|---|---|
| Carly Scholz |
W-2 Managing Employee |
Jan 1, 2020 | |
| Matthew W Forge |
Corporate Officer |
Oct 1, 2022 | |
| Joe Pitzer |
Corporate Director | Dec 19, 2007 |
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040223000506 | WA | Part B Supplier - Clinic/Group Practice | 8325934987 |
Receives reassigned benefits from 151 practitioners 1 other NPI on this enrollment Practice locations: Pullman, WA; Palouse, WA |
| O20070912000859 | WA | Part a Provider - Critical Access Hospital | 8325934987 |
Receives reassigned benefits from 127 practitioners Practice locations: Pullman, WA |
| O20240405000631 | ID | Part B Supplier - Clinic/Group Practice | 8325934987 |
Receives reassigned benefits from 17 practitioners Practice locations: Moscow, ID |
National Provider Directory
Locations
1420 S Blaine St
Moscow, ID 83843
1420 S Blaine St
Ste 5
Moscow, ID 83843
Phone (208) 882-2247
Msc 09 5030
Albuquerque, NM 87131
825 SE Bishop Blvd
Ste 201
Pullman, WA 99163
Phone (509) 336-7577
835 SE Bishop Blvd
Pullman, WA 99163
Phone (509) 332-2541
305 E Main St
Ste 102
Pullman, WA 99163
835 SE Bishop Blvd
Ste 201
Pullman, WA 99163
840 SE Bishop Blvd
Ste 103
Pullman, WA 99163
Phone (509) 336-7300
840 SE Bishop Blvd
Pullman, WA 99163
840 SE Bishop Blvd
Ste 100
Pullman, WA 99163
835 SE Bishop Blvd
Ste 401
Pullman, WA 99163
Phone (509) 332-2541
825 SE Bishop Blvd
Ste 100
Pullman, WA 99163
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Emergency Medical Services (Emergency Medicine) Physician |
207PE0004X | |||
| Radiologic Technologist |
247100000X | |||
| Critical Access Hospital Clinic/Center | 261QC0050X | |||
| Urgent Care Clinic/Center | 261QU0200X | |||
| Critical Access Hospital | 282NC0060X | H-172 | WA | Yes |
| Clinical Medical Laboratory | 291U00000X |
Addresses
Primary practice location
835 SE Bishop Blvd
Pullman, WA 99163-5512
Mailing address
835 SE Bishop Blvd
Pullman, WA 99163-5512
Phone (509) 332-2514
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 003221800 | Medicaid | ID | |
| 3303708 | Medicaid | WA | |
| 003221990 | Medicaid | ID | |
| 82105 | Other | WA | LABOR & IND. (PHYS GROUP) |
| 077 | Other | WA | PREMERA BLUE CROSS |
| 2590 | Other | WA | LABOR & INDUSTRIES (FAC) |
| 7030661 | Medicaid | WA |
Other names
- Pullman Regional Hospital
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- Public Hospital District #1-a of Whitman County
- Public Hospital District #1-a of Whitman County
- Public Hospital District #1-a of Whitman County
- Public Hospital District #1-a of Whitman County
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All providers in Pullman, WA · Critical Access Hospital in Washington
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 22, 2025. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.