NPIMap

Organization Active NPI

Lincoln County Hospital District #3 / North Basin Medical Clinics

  • Health Maintenance Organization
  • Davenport, WA
National Provider Identifier
1497205439
Registry record updated Feb 26, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health Maintenance OrganizationTaxonomy code 302R00000X
Legal business name
LINCOLN COUNTY HOSPITAL DISTRICT #3 / NORTH BASIN MEDICAL CLINICS
Practice address
10 Nicholls St
Davenport, WA 99122-9729
Phone
(509) 725-7501
Fax
(509) 725-7504
NPI assigned
Oct 13, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2026

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

Authorized official

Name
Tyson Lacy
Title
Ceo
Phone
(509) 725-2979

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health Maintenance Organization 302R00000X WA Primary

Addresses

Primary practice location

10 Nicholls St
Davenport, WA 99122-9729

Mailing address

10 Nicholls St
Davenport, WA 99122-9729
Phone (509) 725-7101

Other identifiers 3

IdentifierTypeStateIssuer
7117435OtherWANORTH BASIN MEDICAL REARDAN CLINIC MEDICAID RURAL HEALTH CORE PROVIDER #
7117443OtherWANORTH BASIN MEDICAL WILBUR CLINIC MEDICAID RURAL HEALTH CORE PROVIDER #
7117450OtherWANORTH BASIN MEDICAL DAVENPORT CLINIC MEDICAID RURAL HEALTH CORE PROVIDER #

National Provider Directory

National Provider Directory
Tax ID family
Lincoln Cty Hospital Dist 35 organizations share this tax ID, including this one

Other organizations with this tax ID 4

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

Locations

10 Nicholls St
Davenport, WA 99122
Phone (509) 725-7101

100 3rd St
Davenport, WA 99122
Phone (509) 725-7201

NPI Registry JSON

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

{
    "created_epoch": "1476316800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772064000000",
    "number": "1497205439",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10 NICHOLLS ST",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991229729",
            "telephone_number": "509-725-7101",
            "fax_number": "509-725-2112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10 NICHOLLS ST",
            "city": "DAVENPORT",
            "state": "WA",
            "postal_code": "991229729",
            "telephone_number": "509-725-7501",
            "fax_number": "509-725-7504"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LINCOLN COUNTY HOSPITAL DISTRICT #3 / NORTH BASIN MEDICAL CLINICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-13",
        "last_updated": "2026-02-26",
        "certification_date": "2026-02-26",
        "status": "A",
        "authorized_official_last_name": "LACY",
        "authorized_official_first_name": "TYSON",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "509-725-2979"
    },
    "taxonomies": [
        {
            "code": "302R00000X",
            "taxonomy_group": "",
            "desc": "Health Maintenance Organization",
            "state": "WA",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH BASIN MEDICAL REARDAN CLINIC MEDICAID RURAL HEALTH CORE PROVIDER #",
            "identifier": "7117435",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH BASIN MEDICAL WILBUR CLINIC MEDICAID RURAL HEALTH CORE PROVIDER #",
            "identifier": "7117443",
            "state": "WA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NORTH BASIN MEDICAL DAVENPORT CLINIC MEDICAID RURAL HEALTH CORE PROVIDER #",
            "identifier": "7117450",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Davenport, WA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.